Turkish Journal of Anaesthesiology & Reanimation
ORIGINAL ARTICLE

Prognostic Value of Blood Lactate and Base Deficit in Refractory Cardiac Arrest Cases Undergoing Extracorporeal Life Support

1.

Departments of Anaesthesia and Intensive Care Unit, SAMU, Hôpital Universitaire Necker - Enfants Malades, Université Paris Descartes, Paris, France

Turk J Anaesthesiol Reanim 2019; 47: 407-413
DOI: 10.5152/TJAR.2019.65391
Read: 317 Downloads: 73 Published: 18 September 2019

Objective: Cardiac arrest (CA) resuscitation is associated with an ‘ischaemia-reperfusion’ syndrome characterised by lactic acidosis as assessed by lactate and base deficit (BD). Both biomarkers are usually measured in patients suffering from refractory CA (RCA) subjected to extracorporeal life support (ECLS) to evaluate tissue reperfusion. However, their prognostic value has never been compared. The aim of the present study was to compare the prognostic value of both biomarkers measured at 0 and 3 h after the initiation of ECLS in patients with RCA on mortality.

Methods: Patients who were admitted to the intensive care unit with RCA were consecutively included in the study.

Results: Sixty-six patients were included. Lactate correlated with BD (R2=0.44, p<0.001). An area under the curve of 0.72 (95% confidence interval (CI) 0.59-0.84) was found for lactate and of 0.60 (95% CI 0.46-0.73) for BD. Using multivariable logistic regression, lactate (odds ratio (OR) 1.22, 95% CI 1.03-1.48) remained associated with mortality on day 28, but not BD (OR 0.99, 95% CI 0.86-1.14).

Conclusion: We report a difference in the prognostic value of lactate and BD on mortality. Three hours from the initiation of ECLS in patients with RCA, lactate should be preferred to BD to predict the efficiency of ECLS.

 

Cite this article as: Jouffroy R, Philippe P, Saade A, Carli P, Vivien B. Prognostic Value of Blood Lactate and Base Deficit in Refractory Cardiac Arrest Cases Undergoing Extracorporeal Life Support. Turk J Anaesthesiol Reanim 2019; 47(5): 407-13.

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