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Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation
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- Biancari, Fausto (författare)
- University of Turku,University of Oulu
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- Fiore, Antonio (författare)
- University of Paris-Est
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- Jónsson, Kristján (författare)
- Sahlgrenska University Hospital
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- DellAquila, AM (författare)
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- (creator_code:org_t)
- 2019-12-15
- 2019
- Engelska.
- Ingår i: Journal of Clinical Medicine. - : MDPI AG. - 2077-0383. ; 8:12
- Tidskriftsartikel (refereegranskat)
Abstract
Ämnesord
Stäng
- 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.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
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- Biancari, Fausto
- Fiore, Antonio
- Jónsson, Kristjá ...
- Gatti, Giuseppe
- Zipfel, Svante
- Ruggieri, Vito G
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- Perrotti, Andrea
- Bounader, Karl
- Loforte, Antonio
- Lechiancole, And ...
- Saeed, Diyar
- Lichtenberg, Art ...
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- Spadaccio, Crist ...
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- Mogianos, Kriste ...
- Alkhamees, Khali ...
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- El Dean, Zein
- Settembre, Nicla
- Welp, Henryk
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- Fux, Thomas
- Juvonen, Tatu
- Dalén, Magnus
- DellAquila, AM
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