Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation
(2019) In Journal of Clinical Medicine 8(12).- Abstract
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... (More)
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.
(Less)
- author
- Biancari, Fausto
; Fiore, Antonio
; Jónsson, Kristján
; Gatti, Giuseppe
; Zipfel, Svante
; Ruggieri, Vito G
; Perrotti, Andrea
; Bounader, Karl
; Loforte, Antonio
; Lechiancole, Andrea
; Saeed, Diyar
; Lichtenberg, Artur
; Pol, Marek
; Spadaccio, Cristiano
; Pettinari, Matteo
; Mogianos, Krister
LU
; Alkhamees, Khalid
; Mariscalco, Giovanni
; El Dean, Zein
; Settembre, Nicla
; Welp, Henryk
; Dell'Aquila, Angelo M
; Fux, Thomas
; Juvonen, Tatu
and Dalén, Magnus
(Less) - organization
- publishing date
- 2019-12-15
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Clinical Medicine
- volume
- 8
- issue
- 12
- article number
- 2218
- publisher
- MDPI AG
- external identifiers
-
- scopus:85096161118
- pmid:31847464
- ISSN
- 2077-0383
- DOI
- 10.3390/jcm8122218
- language
- English
- LU publication?
- yes
- id
- 7f4f08bf-d12c-479a-a6c1-e7f0f80f4a42
- date added to LUP
- 2023-11-16 10:08:59
- date last changed
- 2024-04-14 16:55:56
@article{7f4f08bf-d12c-479a-a6c1-e7f0f80f4a42,
abstract = {{<p>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.</p><p>METHODS: This analysis included 338 patients from the multicenter PC-ECMO registry with available data on arterial lactate levels at weaning from VA-ECMO.</p><p>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.</p><p>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.</p>}},
author = {{Biancari, Fausto and Fiore, Antonio and Jónsson, Kristján and Gatti, Giuseppe and Zipfel, Svante and Ruggieri, Vito G and Perrotti, Andrea and Bounader, Karl and Loforte, Antonio and Lechiancole, Andrea and Saeed, Diyar and Lichtenberg, Artur and Pol, Marek and Spadaccio, Cristiano and Pettinari, Matteo and Mogianos, Krister and Alkhamees, Khalid and Mariscalco, Giovanni and El Dean, Zein and Settembre, Nicla and Welp, Henryk and Dell'Aquila, Angelo M and Fux, Thomas and Juvonen, Tatu and Dalén, Magnus}},
issn = {{2077-0383}},
language = {{eng}},
month = {{12}},
number = {{12}},
publisher = {{MDPI AG}},
series = {{Journal of Clinical Medicine}},
title = {{Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation}},
url = {{http://dx.doi.org/10.3390/jcm8122218}},
doi = {{10.3390/jcm8122218}},
volume = {{8}},
year = {{2019}},
}