Abstract
Objective
To examine whether values of arterial base excess or lactate taken 3 h after starting ECLS indicate poor prognosis and if this can be used as a screening
tool to follow Extra Corporeal Life Support after Out Hospital Cardiac Arrest due
to acute coronary syndrome.
Design
Single Centre retrospective observational study.
Setting
University teaching hospital general adult intensive care unit.
Patients
15 consecutive patients admitted to the intensive care unit after refractory Out Hospital
Cardiac Arrest due to acute coronary syndrome treated by Extra Corporeal Life Support.
Interventions
Arterial base excess and lactate concentrations were measured immediately after starting
ECLS and every 3 h after.
Results
Both base excess and arterial lactate measured 3 h after starting ECLS effectively predict multiorgan failure occurrence and mortality
in the following 21 h (area under the curve on receiver operating characteristic analysis of 0.97, 0.95
respectively). The best predictive values were obtained with a base excess level measured
3 h after starting ECLS of less than −10 mmol/l and lactate concentrations greater than 12 mmol/l. The combination of these two markers measured 3 h after starting ECLS predicted multiorgan failure occurrence and mortality in the
following 21 h with a sensitivity of 70% and a specificity of 100%.
Conclusions
Combination of base excess and lactate, measured 3 h after starting ECLS, can be used to predict multiorgan failure occurrence and mortality
in the following 21 h in patients admitted to an intensive care unit for refractory Out Hospital Cardiac
Arrest due to acute coronary syndrome treated by Extra Corporeal Life Support. These
parameters can be obtained simply and rapidly and help in the decision process to
continue ECLS for refractory CA.
Keywords
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Article info
Publication history
Published online: October 22, 2014
Accepted:
October 13,
2014
Received in revised form:
October 1,
2014
Received:
May 18,
2014
Footnotes
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at http://dx.doi.org/10.1016/j.resuscitation.2014.10.012.
Identification
Copyright
© 2014 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
