Prognostic value of Blood Lactate versus Base Deficit 3 hours from Extra Corporeal Life Support in refractory cardiac arrest [Turk J Anaesthesiol Reanim]
Turk J Anaesthesiol Reanim. Ahead of Print: TARD-65391

Prognostic value of Blood Lactate versus Base Deficit 3 hours from Extra Corporeal Life Support in refractory cardiac arrest

Romain Jouffroy, Pascal Philippe, Anastasia Saade, Pierre Carli, Benoit Vivien
Departments of Anaesthesia & Intensive Care Unit, SAMU, Hôpital Universitaire Necker - Enfants Malades, Université Paris Descartes, 149 rue de Sèvres, 75015 Paris, France.

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

Methods: Patients admitted to intensive care unit with RCA were consecutively included.
Results: Sixty-six patients were included. Lactate correlated with BD (R2=0.44; p<0.001). An AUC of 0.72 (95% 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 (OR=1.22, 95% CI [1.03-1.48]) remained associated with mortality at 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.

Keywords: Blood lactate, base deficit, prognosis, refractory cardiac arrest, extra corporeal life support.




Corresponding Author: Romain Jouffroy, France


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