Correlation between initial serum levels of lactate after return of spontaneous circulation and survival and neurological outcomes in patients who undergo therapeutic hypothermia after cardiac arrest

Lee, Dong Hoon; Cho, In Soo; Lee, Sun Hwa; Min, Yong‐Ki; Min, Jin Hong; Kim, Soo Hyun; Lee, Young Hwan

doi:10.1016/j.resuscitation.2014.11.005

Cited by 59 publications

(38 citation statements)

References 25 publications

(31 reference statements)

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“…30 Our data corroborated in part the results previously published by Donnino et al from a retrospective study evaluating 79 out-ofhospital patients in a post-CA state. The authors demonstrated a statistically significant difference in Clac at 6 hours and 12 hours between survivors and nonsurvivors at 24 hours and the hospital mortality, which was not observed with the initial lactate levels.…”

Section: Discussionsupporting

confidence: 92%

Evaluation of Serum Lactate, Central Venous Saturation, and Venous-Arterial Carbon Dioxide Difference in the Prediction of Mortality in Postcardiac Arrest Syndrome

Riveiro

Oliveira

Braunner

et al. 2016

J Intensive Care Med

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Section: Discussionsupporting

confidence: 92%

Evaluation of Serum Lactate, Central Venous Saturation, and Venous-Arterial Carbon Dioxide Difference in the Prediction of Mortality in Postcardiac Arrest Syndrome

Riveiro

Oliveira

Braunner

et al. 2016

J Intensive Care Med

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“…Moreover, Roberts et al [8] did not record blood lactate levels and we observed that increased lactate concentrations after CA were significantly associated with ICU mortality. As high lactate concentrations are primarily a consequence of prolonged CA and/or severe subsequent hemodynamic impairment [22–24], lactate can be considered as an extracerebral variable that is predictive of poor outcome in these patients. Abnormalities in tissue perfusion occurring after CA may also potentially contribute to brain hypoperfusion and development of MOF [7].…”

Section: Discussionmentioning

confidence: 99%

“…Thus, monitoring of lactate in this setting may be of more value to assess the severity of tissue hypoxia than just blood pressure or cardiac output. Other studies have also shown the prognostic value of admission blood lactate levels after CA and of changes in lactate levels in the hours after CA [22–25]. …”

Section: Discussionmentioning

confidence: 99%

The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database

et al. 2016

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BackgroundWe used data from a large international database to assess the incidence and impact of extracerebral organ dysfunction on prognosis of patients admitted after cardiac arrest (CA).MethodsThis was a sub-analysis of the Intensive Care Over Nations (ICON) database, which contains data from all adult patients admitted to one of 730 participating intensive care units (ICUs) in 84 countries from 8–18 May 2012, except admissions for routine postoperative surveillance. For this analysis, patients admitted after CA (defined as those with “post-anoxic coma” or “cardiac arrest” as the reason for ICU admission) were included. Data were collected daily in the ICU for a maximum of 28 days; patients were followed up for outcome data until death, hospital discharge, or a maximum of 60 days in-hospital. Favorable neurological outcome was defined as alive at hospital discharge with a last available neurological Sequential Organ Failure Assessment (SOFA) subscore of 0–2.ResultsAmong the 469 patients admitted after CA, 250 (53 %) had had out-of-hospital CA; 210 (45 %) patients died in the ICU and 357 (76 %) had an unfavorable neurological outcome. Non-survivors had a higher incidence of renal (43 vs. 16 %), cardiovascular (56 vs. 45 %), and respiratory (62 vs. 48 %) failure on admission and during the ICU stay than survivors (all p < 0.05). Similar results were found for patients with unfavorable vs. favorable neurological outcomes. In multivariable analysis, independent predictors of ICU mortality were renal failure on admission, high admission Simplified Acute Physiology Score (SAPS) II, high maximum serum lactate levels within the first 24 h after ICU admission, and development of sepsis. Independent predictors of unfavorable neurological outcome were mechanical ventilation on admission, high admission SAPS II score, and neurological dysfunction on admission.ConclusionsIn this multicenter cohort, extracerebral organ dysfunction was common in CA patients. Renal failure on admission was the only extracerebral organ dysfunction independently associated with higher ICU mortality.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1528-6) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 98%

“…Moreover, Roberts et al [8] did not record blood lactate levels and we observed that increased lactate concentrations after CA were significantly associated with ICU mortality. As high lactate concentrations are primarily a consequence of prolonged CA and/or severe subsequent hemodynamic impairment [22][23][24], lactate can be considered as an extracerebral variable that is predictive of poor outcome in these patients. Abnormalities in tissue perfusion occurring after CA may also potentially contribute to brain hypoperfusion and development of MOF [7].…”

Section: Discussionmentioning

confidence: 99%

APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management

Kim¹,

Kim²,

Lee³

et al. 2018

Acute Crit Care

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Background: We used data from a large international database to assess the incidence and impact of extracerebral organ dysfunction on prognosis of patients admitted after cardiac arrest (CA). Methods: This was a sub-analysis of the Intensive Care Over Nations (ICON) database, which contains data from all adult patients admitted to one of 730 participating intensive care units (ICUs) in 84 countries from 8-18 May 2012, except admissions for routine postoperative surveillance. For this analysis, patients admitted after CA (defined as those with "post-anoxic coma" or "cardiac arrest" as the reason for ICU admission) were included. Data were collected daily in the ICU for a maximum of 28 days; patients were followed up for outcome data until death, hospital discharge, or a maximum of 60 days in-hospital. Favorable neurological outcome was defined as alive at hospital discharge with a last available neurological Sequential Organ Failure Assessment (SOFA) subscore of 0-2. Results: Among the 469 patients admitted after CA, 250 (53 %) had had out-of-hospital CA; 210 (45 %) patients died in the ICU and 357 (76 %) had an unfavorable neurological outcome. Non-survivors had a higher incidence of renal (43 vs. 16 %), cardiovascular (56 vs. 45 %), and respiratory (62 vs. 48 %) failure on admission and during the ICU stay than survivors (all p < 0.05). Similar results were found for patients with unfavorable vs. favorable neurological outcomes. In multivariable analysis, independent predictors of ICU mortality were renal failure on admission, high admission Simplified Acute Physiology Score (SAPS) II, high maximum serum lactate levels within the first 24 h after ICU admission, and development of sepsis. Independent predictors of unfavorable neurological outcome were mechanical ventilation on admission, high admission SAPS II score, and neurological dysfunction on admission. Conclusions: In this multicenter cohort, extracerebral organ dysfunction was common in CA patients. Renal failure on admission was the only extracerebral organ dysfunction independently associated with higher ICU mortality.

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Correlation between initial serum levels of lactate after return of spontaneous circulation and survival and neurological outcomes in patients who undergo therapeutic hypothermia after cardiac arrest

Cited by 59 publications

References 25 publications

Evaluation of Serum Lactate, Central Venous Saturation, and Venous-Arterial Carbon Dioxide Difference in the Prediction of Mortality in Postcardiac Arrest Syndrome

Evaluation of Serum Lactate, Central Venous Saturation, and Venous-Arterial Carbon Dioxide Difference in the Prediction of Mortality in Postcardiac Arrest Syndrome

The impact of extracerebral organ failure on outcome of patients after cardiac arrest: an observational study from the ICON database

APACHE II Score Immediately after Cardiac Arrest as a Predictor of Good Neurological Outcome in Out-of-Hospital Cardiac Arrest Patients Receiving Targeted Temperature Management

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