Slottosch, Ingo, Liakopoulos, Oliver, Kuhn, Elmar, Scherner, Maximilian, Deppe, Antje-Christin, Sabashnikov, Anton, Mader, Navid, Choi, Yeong-Hoon, Wippermann, Jens and Wahlers, Thorsten (2017). Lactate and lactate clearance as valuable tool to evaluate ECMO therapy in cardiogenic shock. J. Crit. Care, 42. S. 35 - 42. PHILADELPHIA: W B SAUNDERS CO-ELSEVIER INC. ISSN 1557-8615

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Abstract

Purpose: ECMO support is an ultimate ratio therapy for patients in refractory cardiogenic shock and is linked to high mortality. We assessed the dynamic characteristics of lactate during ECMO therapy and its predictive role on 30-day mortality. Materials and methods: Data were retrospectively collected in all patients receiving ECMO support longer than 48 h for cardiogenic shock from 01/2008 to 12/2016. Blood lactate was recorded before ECMO implantation, at prespecified timepoints during ECMO support, 1 h and 6 h post-ECMO as well as peak lactate during ECMO and peak within 24 h after ECMO support. Statistical analysis included t-test and ROC-curves to identify cut-off levels for lactate levels to predict 30-day mortality. Results: 139 patients underwent ECMO therapy longer than 48 h for refractory cardiogenic shock resulting in a 30-day mortality of 68%. Lactate before ECMO and peak lactate level during ECMO support showed no significant connection to mortality, while lactate and lactate clearance at 24 h were predictive for 30-day mortality with cutoff values of 2.15 mmol/l and 0.687 respectively. Conclusions: Dynamic course of lactate during ECMO therapy is a valuable tool to assess effective circulatory support and is superior to single lactate measurements as a predictive marker for 30-day mortality. (C) 2017 Elsevier Inc. All rights reserved.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Slottosch, IngoUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Liakopoulos, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kuhn, ElmarUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scherner, MaximilianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Deppe, Antje-ChristinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sabashnikov, AntonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mader, NavidUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Choi, Yeong-HoonUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wippermann, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wahlers, ThorstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-210233
DOI: 10.1016/j.jcrc.2017.06.022
Journal or Publication Title: J. Crit. Care
Volume: 42
Page Range: S. 35 - 42
Date: 2017
Publisher: W B SAUNDERS CO-ELSEVIER INC
Place of Publication: PHILADELPHIA
ISSN: 1557-8615
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
EXTRACORPOREAL MEMBRANE-OXYGENATION; BLOOD LACTATE; LIFE-SUPPORT; CARDIOPULMONARY BYPASS; CARDIAC-FAILURE; ADULT PATIENTS; MORTALITY; OUTCOMES; CANNULATION; EXPERIENCEMultiple languages
Critical Care MedicineMultiple languages
Refereed: Yes
URI: http://kups.ub.uni-koeln.de/id/eprint/21023

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