Use of plasma lactate to predict early mortality and adverse outcome after neonatal extracorporeal membrane oxygenation: A prospective cohort in early childhood*

Cheung, Po–Yin; Etches, Philip C.; Weardon, M.; Reynolds, Ann Marie; Finer, Neil N.; Robertson, Charlene M.T.

doi:10.1097/00003246-200209000-00030

Cited by 39 publications

(37 citation statements)

References 13 publications

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“…As for other critically ill children, lactate levels were predictive of mortality. 40 This study explored stages of cumulative risk factors and sought modifiable determinants of adverse outcome before, during, and after OHS. Overall, multivariate analyses explain 55% of the variance of outcome: 23% from the preoperative stage, 18% from the intraoperative stage, and 14% from the postoperative stages.…”

Section: Discussionmentioning

confidence: 99%

Outcomes from an interprovincial program of newborn open heart surgery

Robertson

Joffe

Sauve

et al. 2004

The Journal of Pediatrics

104

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Section: Discussionmentioning

confidence: 99%

Outcomes from an interprovincial program of newborn open heart surgery

Robertson

Joffe

Sauve

et al. 2004

The Journal of Pediatrics

104

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“…We think that this notion is most important in septic patients who have increased mortality. Rare combinations can be seen in daily clinical practice, and those combinations were also discussed in previous studies (Table 3) (6,9,13,(15)(16)(17)(18)(19). Kurt et al (15) indicated the presence of hypochloremic metabolic acidosis in 16% of acid-base disorders.…”

Section: Classification and Calculationsmentioning

confidence: 76%

The effects of the chloride:sodium ratio on acid-base statusand mortality in septic patients

Atalan¹,

Güçyetmez²

2017

Turk J Med Sci

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IntroductionAcid-base disorder is an important issue that requires an urgent solution in the intensive care unit (ICU) (1). Stewart's physiochemical approach provides practical solutions for the understanding of metabolic acid-base disorders (2-4). However, this approach has limitations that prevent intensivists from completing a fast bedside assessment. Therefore, methods enabling fast and accurate bedside assessment are needed. Recently, simpler and more practical approaches, such as assessments of Cland Na + differences, Cl -:Na + ratio evaluation, and base excesschloride (BE Cl ) calculations, have been used (5,6). Duward et al. (6) evaluated acid-base disorders in accordance with pH, pCO 2 , and Clchanges. According to Duward et al. (6), the main reason for the changes in the HCO 3 pool is changes in Cl -. Moreover, Clmust always be interpreted together with Na + , and the simplest method of achieving this interpretation is calculation of the Cl -:Na + ratio. Hypochloremia or hyperchloremia should be considered in accordance with the Cl -:Na + ratio. Regardless of the individual Cland Na + concentrations, the Cl -:Na + ratio may be low or high. This notion makes the contribution of Clto acid-base disorder more comprehensible. It is indicated that a strong ion difference (SID) is related to mortality (7,8). Hypochloremia, hyperchloremia, and dysnatremia are also known to be associated with increased mortality (9-11). Thus, the Cl:Na + ratio can also be associated with increased mortality. In the present study, the relationship between the Cl -:Na + ratio in septic patients at ICU admission and each of the other components of the acid-base balance and ICU mortality was investigated. Material and methods Study designEthics committee approval was obtained from the Acıbadem University Medical Research Council for the present study. A total of 2691 patients admitted to the Acıbadem International Hospital ICU and Ataşehir Memorial ICU between 1 January 2006 and 31 December 2012 were retrospectively evaluated. Patients who were Background/aim: Calculation of the chloride:sodium (Cl -:Na + ) ratio is proposed to enable a quick evaluation of the effect of Cland Na + on the acid-base balance in critically ill patients. In the present study, the relationship of the Cl -:Na + ratio of septic patients with acidbase status and ICU mortality were investigated. Materials and methods:In our two-center study, 434 patients who were diagnosed with sepsis were included. The patients were divided into three groups: low (<0.75), normal (≥0.75, <0.80), and high (≥0.80) Cl -:Na + ratio groups. Patients' demographic data, blood gas values, length of ICU stay, and ICU mortality were recorded. Results:In the low and high groups, ICU mortality was significantly higher than in the normal group (29.3%, 37.1%) (P = 0.005). There was a negative correlation between the Cl:Na + ratio and each of HCO 3 -, standard base excess, and PaCO 2 (r 2 = 0.21, r 2 = 0.19, and r 2 = 0.17) (P < 0.001 for each). In the multivariate analysis, the ICU mortal...

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“…However, these predictors identified are inconsistent among the previous studies. For instance, in a retrospective study of 49 neonates with severe hypoxemia requiring ECMO, the authors found that plasma lactate level higher than 25 mM was associated with higher mortality [15]. In adults, hyperlactatemia has been proven to be correlated well with mortality in ICU patients.…”

Section: Discussionmentioning

confidence: 99%

“…The ECMO support was performed as described previously [4,6,15]. In brief, our ECMO device (Medtronic Inc, Anaheim, CA) consisted of a centrifugal pump and a hollow-fiber microporous membrane oxygenator with an integrated heater.…”

Section: Ecmo Devicementioning

confidence: 99%

SAPS 3 at dialysis commencement is predictive of hospital mortality in patients supported by extracorporeal membrane oxygenation and acute dialysis☆

Tsai

Lin

et al. 2008

European Journal of Cardio-Thoracic Surgery

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Objective: This study examined the association between hospital mortality and five illness-severity scoring systems evaluated at different time points in the intensive care unit (ICU) as well as clinical variables as predictors in critically ill patients supported by extracorporeal membrane oxygenation (ECMO) and acute dialysis. Methods: This multicenter prospective observational study included 104 patients who received ECMO support and acute dialysis from January 2002 to December 2006. Patients' demographic, clinical and laboratory variables were analyzed as predictors of survival. The SAPS 2, APACHE II, SOFA, MODS, and SAPS 3 scores upon ICU admission and at acute dialysis commencement were evaluated to predict the patient's hospital mortality. Results: Hospital mortality for the study group was 76% (79/104). Among the five scoring systems, only SAPS 3 score showed a significant difference between survivors and non-survivors either upon ICU admission ( p = 0.038) or at dialysis commencement ( p = 0.001). SAPS 3 score at dialysis commencement showed the best discrimination ability by using the area under the receiver operating characteristic curve (SOFA, 0.55; SAPS 2, 0.56; MODS, 0.58; APACHE II, 0.59; and SAPS 3, 0.73). Multiple logistic regression analysis indicated that SAPS 3 score at dialysis commencement (OR: 1.070, 95% CI: 1.016-1.216) and IABP usage before ECMO (OR: 4.181, 95% CI: 1.448-12.075) were two independent risk factors for hospital mortality. Conclusions: Among five common ICU scoring systems evaluated at different time points, SAPS 3 at dialysis commencement is the best risk adjustment systems to predict hospital mortality in critically ill patients supported by ECMO and acute dialysis. Furthermore, the SAPS 3 score at dialysis commencement and IABP usage before ECMO are two major independent predictors for hospital mortality in patients supported by ECMO and acute dialysis. #

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Use of plasma lactate to predict early mortality and adverse outcome after neonatal extracorporeal membrane oxygenation: A prospective cohort in early childhood*

Cited by 39 publications

References 13 publications

Outcomes from an interprovincial program of newborn open heart surgery

Outcomes from an interprovincial program of newborn open heart surgery

The effects of the chloride:sodium ratio on acid-base statusand mortality in septic patients

SAPS 3 at dialysis commencement is predictive of hospital mortality in patients supported by extracorporeal membrane oxygenation and acute dialysis☆

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