Universität zu Köln

Slottosch, Ingo, Liakopoulos, Oliver, Kuhn, Elmar, Scherner, Maximilian, Deppe, Antje-Christin, Sabashnikov, Anton, Mader, Navid, Choi, Yeong-Hoon, Wippermann, Jens and Wahlers, Thorsten (2017). Lactate and lactate clearance as valuable tool to evaluate ECMO therapy in cardiogenic shock. J. Crit. Care, 42. S. 35 - 42. PHILADELPHIA: W B SAUNDERS CO-ELSEVIER INC. ISSN 1557-8615

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Abstract

Purpose: ECMO support is an ultimate ratio therapy for patients in refractory cardiogenic shock and is linked to high mortality. We assessed the dynamic characteristics of lactate during ECMO therapy and its predictive role on 30-day mortality. Materials and methods: Data were retrospectively collected in all patients receiving ECMO support longer than 48 h for cardiogenic shock from 01/2008 to 12/2016. Blood lactate was recorded before ECMO implantation, at prespecified timepoints during ECMO support, 1 h and 6 h post-ECMO as well as peak lactate during ECMO and peak within 24 h after ECMO support. Statistical analysis included t-test and ROC-curves to identify cut-off levels for lactate levels to predict 30-day mortality. Results: 139 patients underwent ECMO therapy longer than 48 h for refractory cardiogenic shock resulting in a 30-day mortality of 68%. Lactate before ECMO and peak lactate level during ECMO support showed no significant connection to mortality, while lactate and lactate clearance at 24 h were predictive for 30-day mortality with cutoff values of 2.15 mmol/l and 0.687 respectively. Conclusions: Dynamic course of lactate during ECMO therapy is a valuable tool to assess effective circulatory support and is superior to single lactate measurements as a predictive marker for 30-day mortality. (C) 2017 Elsevier Inc. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Slottosch, Ingo UNSPECIFIED UNSPECIFIED UNSPECIFIED Liakopoulos, Oliver UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn, Elmar UNSPECIFIED UNSPECIFIED UNSPECIFIED Scherner, Maximilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Deppe, Antje-Christin UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Mader, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Choi, Yeong-Hoon UNSPECIFIED UNSPECIFIED UNSPECIFIED Wippermann, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-210233
DOI:	10.1016/j.jcrc.2017.06.022
Journal or Publication Title:	J. Crit. Care
Volume:	42
Page Range:	S. 35 - 42
Date:	2017
Publisher:	W B SAUNDERS CO-ELSEVIER INC
Place of Publication:	PHILADELPHIA
ISSN:	1557-8615
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language EXTRACORPOREAL MEMBRANE-OXYGENATION; BLOOD LACTATE; LIFE-SUPPORT; CARDIOPULMONARY BYPASS; CARDIAC-FAILURE; ADULT PATIENTS; MORTALITY; OUTCOMES; CANNULATION; EXPERIENCE Multiple languages Critical Care Medicine Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21023