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

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TitrePrognostic Significance of Arterial Lactate Levels at Weaning from Postcardiotomy Venoarterial Extracorporeal Membrane Oxygenation
Type de publicationJournal Article
Year of Publication2019
AuteursBiancari F, Fiore A, Jonsson K, Gatti G, Zipfel S, Ruggieri VG, Perrotti A, Bounader K, Loforte A, Lechiancole A, Saeed D, Lichtenberg A, Pol M, Spadaccio C, Pettinari M, Mogianos K, Alkhamees K, Mariscalco G, Dean ZEl, Settembre N, Welp H, DellAquila AM, Fux T, Juvonen T, Dalen M
JournalJOURNAL OF CLINICAL MEDICINE
Volume8
Pagination2218
Date PublishedDEC
Type of ArticleArticle
Mots-clésCardiac surgery, ECMO, Extracorporeal membrane oxygenation, postcardiotomy, VA-ECMO, venoarterial
Résumé

{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%
DOI10.3390/jcm8122218