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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; Alkhamees, Khalid; Mariscalco, Giovanni; El Dean, Zein; Settembre, Nicla; Welp, Henryk; Dell’Aquila, Angelo M.; Fux, Thomas; Juvonen, Tatu;

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

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  • Medientyp: E-Artikel
  • Titel: Prognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation
  • Beteiligte: 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; Alkhamees, Khalid; Mariscalco, Giovanni; El Dean, Zein; Settembre, Nicla; Welp, Henryk; Dell’Aquila, Angelo M.; Fux, Thomas; Juvonen, Tatu;
  • Erschienen: MDPI AG, 2019
  • Erschienen in: Journal of Clinical Medicine, 8 (2019) 12, Seite 2218
  • Sprache: Englisch
  • DOI: 10.3390/jcm8122218
  • ISSN: 2077-0383
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: 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.
  • Zugangsstatus: Freier Zugang