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Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation

Biancari, Fausto (author)
University of Turku,University of Oulu
Fiore, Antonio (author)
University of Paris-Est
Jónsson, Kristján (author)
Sahlgrenska University Hospital
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Gatti, Giuseppe (author)
University Hospital Of Trieste
Zipfel, Svante (author)
University Heart & Vascular Center Hamburg
Ruggieri, Vito G (author)
Robert Debré University Hospital
Perrotti, Andrea (author)
University Hospital Jean Minjoz
Bounader, Karl (author)
Pontchaillou University Hospital
Loforte, Antonio (author)
University of Bologna
Lechiancole, Andrea (author)
University Hospital of Udine
Saeed, Diyar (author)
University Hospital of Düsseldorf
Lichtenberg, Artur (author)
University Hospital of Düsseldorf
Pol, Marek (author)
Institute for Clinical and Experimental Medicine (IKEM)
Spadaccio, Cristiano (author)
Golden Jubilee National Hospital
Pettinari, Matteo (author)
Zhongnan Hospital of Wuhan University
Mogianos, Krister (author)
Lund University,Lunds universitet,Anestesiologi och intensivvård,Forskargrupper vid Lunds universitet,Anaesthesiology and Intensive Care Medicine,Lund University Research Groups
Alkhamees, Khalid (author)
Prince Sultan Cardiac Center
Mariscalco, Giovanni (author)
University Hospitals of Leicester NHS Trust
El Dean, Zein (author)
University Hospitals of Leicester NHS Trust
Settembre, Nicla (author)
University of Lorraine
Welp, Henryk (author)
University Hospital Münster
Dell'Aquila, Angelo M (author)
University Hospital Münster
Fux, Thomas (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
Juvonen, Tatu (author)
Helsinki University of Technology,University of Oulu
Dalén, Magnus (author)
Karolinska Institutet,Karolinska Institute,Karolinska University Hospital
DellAquila, AM (author)
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 (creator_code:org_t)
2019-12-15
2019
English.
In: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 8:12
Related links:
http://dx.doi.org/10... (free)
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https://www.mdpi.com...
https://lup.lub.lu.s...
https://doi.org/10.3...
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • BACKGROUND: The outcome after weaning from postcardiotomy venoarterial extracorporeal membrane oxygenation (VA-ECMO) is poor. In this study, we investigated the prognostic impact of arterial lactate levels at the time of weaning from postcardiotomy VA.METHODS: This analysis included 338 patients from the multicenter PC-ECMO registry with available data on arterial lactate levels at weaning from VA-ECMO.RESULTS: Arterial lactate levels at weaning from VA-ECMO (adjusted OR 1.426, 95%CI 1.157-1.758) was an independent predictor of hospital mortality, and its best cutoff values was 1.6 mmol/L (<1.6 mmol/L, 26.2% vs. ≥ 1.6 mmol/L, 45.0%; adjusted OR 2.489, 95%CI 1.374-4.505). When 261 patients with arterial lactate at VA-ECMO weaning ≤2.0 mmol/L were analyzed, a cutoff of arterial lactate of 1.4 mmol/L for prediction of hospital mortality was identified (<1.4 mmol/L, 24.2% vs. ≥1.4 mmol/L, 38.5%, p = 0.014). Among 87 propensity score-matched pairs, hospital mortality was significantly higher in patients with arterial lactate ≥1.4 mmol/L (39.1% vs. 23.0%, p = 0.029) compared to those with lower arterial lactate.CONCLUSIONS: Increased arterial lactate levels at the time of weaning from postcardiotomy VA-ECMO increases significantly the risk of hospital mortality. Arterial lactate may be useful in guiding optimal timing of VA-ECMO weaning.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

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