Universität zu Köln

Merkle-Storms, Julia, Djordjevic, Ilija ORCID: 0000-0002-5810-8626, Weber, Carolyn, Avgeridou, Soi, Krasivskyi, Ihor ORCID: 0000-0003-0573-8218, Gaisendrees, Christopher ORCID: 0000-0002-7232-3330, Mader, Navid, Kuhn-Regnier, Ferdinand, Kroner, Axel, Bennink, Gerardus, Sabashnikov, Anton, Trieschmann, Uwe, Wahlers, Thorsten and Menzel, Christoph (2021). Impact of Lactate Clearance on Early Outcomes in Pediatric ECMO Patients. Med. Lith., 57 (3). BASEL: MDPI. ISSN 1648-9144

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Abstract

Background and Objectives: Pediatric extracorporeal membrane oxygenation (ECMO) support is often the ultimate therapy for neonatal and pediatric patients with congenital heart defects after cardiac surgery. The impact of lactate clearance in pediatric patients during ECMO therapy on outcomes has been analyzed. Materials and Methods: We retrospectively analyzed data from 41 pediatric vaECMO patients between January 2006 and December 2016. Blood lactate and lactate clearance have been recorded prior to ECMO implantation and 3, 6, 9 and 12 h after ECMO start. Receiver operating characteristic (ROC) analysis was used to identify cut-off levels for lactate clearance. Results: Lactate levels prior to ECMO therapy (9.8 mmol/L vs. 13.5 mmol/L; p = 0.07) and peak lactate levels during ECMO support (10.4 mmol/L vs. 14.7 mmol/L; p = 0.07) were similar between survivors and nonsurvivors. Areas under the curve (AUC) of lactate clearance at 3, 9 h and 12 h after ECMO start were significantly predictive for mortality (p = 0.017, p = 0.049 and p = 0.006, respectively). Cut-off values of lactate clearance were 3.8%, 51% and 56%. Duration of ECMO support and respiratory ventilation was significantly longer in survivors than in nonsurvivors (p = 0.01 and p < 0.001, respectively). Conclusions: Dynamic recording of lactate clearance after ECMO start is a valuable tool to assess outcomes and effectiveness of ECMO application. Poor lactate clearance during ECMO therapy in pediatric patients is a significant marker for higher mortality.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Merkle-Storms, Julia UNSPECIFIED UNSPECIFIED UNSPECIFIED Djordjevic, Ilija UNSPECIFIED orcid.org/0000-0002-5810-8626 UNSPECIFIED Weber, Carolyn UNSPECIFIED UNSPECIFIED UNSPECIFIED Avgeridou, Soi UNSPECIFIED UNSPECIFIED UNSPECIFIED Krasivskyi, Ihor UNSPECIFIED orcid.org/0000-0003-0573-8218 UNSPECIFIED Gaisendrees, Christopher UNSPECIFIED orcid.org/0000-0002-7232-3330 UNSPECIFIED Mader, Navid UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhn-Regnier, Ferdinand UNSPECIFIED UNSPECIFIED UNSPECIFIED Kroner, Axel UNSPECIFIED UNSPECIFIED UNSPECIFIED Bennink, Gerardus UNSPECIFIED UNSPECIFIED UNSPECIFIED Sabashnikov, Anton UNSPECIFIED UNSPECIFIED UNSPECIFIED Trieschmann, Uwe UNSPECIFIED UNSPECIFIED UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Menzel, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-563202
DOI:	10.3390/medicina57030284
Journal or Publication Title:	Med. Lith.
Volume:	57
Number:	3
Date:	2021
Publisher:	MDPI
Place of Publication:	BASEL
ISSN:	1648-9144
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language Medicine, General & Internal Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56320