دورية أكاديمية
Serial daily lactate levels association with 30-day outcome in cardiogenic shock patients treated with VA-ECMO: a post-hoc analysis of the HYPO-ECMO study
| العنوان: | Serial daily lactate levels association with 30-day outcome in cardiogenic shock patients treated with VA-ECMO: a post-hoc analysis of the HYPO-ECMO study |
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| المؤلفون: | Levy, Bruno, Girerd, Nicolas, Baudry, Guillaume, Duarte, Kevin, Cuau, Samuel, Bakker, Jan, Kimmoun, Antoine |
| المساهمون: | Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre d'investigation clinique plurithématique Pierre Drouin Nancy (CIC-P), Centre d'investigation clinique Nancy (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Cardiovascular and Renal Clinical Trialists Vandoeuvre-les-Nancy (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu Nancy, French-Clinical Research Infrastructure Network - F-CRIN Paris (Cardiovascular & Renal Clinical Trialists - CRCT ), Université de Lorraine (UL), Erasmus University Medical Center Rotterdam (Erasmus MC), Columbia University Medical Center (CUMC), Columbia University New York, New York University School of Medicine (NYU), New York University School of Medicine, NYU System (NYU)-NYU System (NYU), Pontificia Universidad Católica de Chile (UC), French Health ministry (PHRC 2015) |
| المصدر: | ISSN: 2110-5820 ; Annals of Intensive Care ; https://hal.univ-lorraine.fr/hal-04525267Test ; Annals of Intensive Care, 2024, 14 (1), pp.43. ⟨10.1186/s13613-024-01266-6⟩. |
| بيانات النشر: | HAL CCSD SpringerOpen |
| سنة النشر: | 2024 |
| المجموعة: | Université de Lorraine: HAL |
| مصطلحات موضوعية: | Cardiogenic shock Lactate Extracorporeal Membrane Oxygenation Hypothermia, Cardiogenic shock, Lactate, Extracorporeal Membrane Oxygenation, Hypothermia, [SDV]Life Sciences [q-bio] |
| الوصف: | International audience ; Abstract Background Reliable predictors of outcomes in venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy are limited. While elevated lactate levels over time have been linked to outcomes in cardiogenic shock (CS), their significance in VA-ECMO-treated patients remains inconclusive. Methods We conducted a post hoc analysis of data from the HYPO-ECMO trial, which compared normothermia to moderate hypothermia in CS patients supported by VA-ECMO. We examined daily lactate levels collected over a week to assess their correlation with 30-day mortality. Results Among the 318 out of 334 patients (95%) with baseline lactate measurements, 66 had normal levels (< 2.2 mmol/l, 21%). No difference was found in lactate course between moderate hypothermia and normothermia groups. Lactate levels were consistently higher in non-survivors at each time point (p = 0.0002). Baseline hyperlactatemia was associated with an increased risk of death (Hazard Ratio [HR]: 1.85 (1.12–3.05), p = 0.016). When considering all time points, lactate levels during the ICU stay were significantly and gradually associated with a higher risk of death (p < 0.0001). In the overall population, a decrease in lactate levels was not linked to 30-day mortality. However, patients with baseline hyperlactatemia exhibited a more significant decrease in lactate levels from day one to seven (p < 0.0001). In this group, survivors had a significantly greater decrease in lactate levels at day 1 compared to non-survivors (63% (48–77) versus 57% (21–75), p = 0.026). Patients experiencing a secondary increase in lactate (24%) had a worse prognosis (Hazard Ratio: 1.78 (1.21–2.61), p = 0.004), regardless of both baseline lactate levels and the occurrence of severe ischemic adverse events (intestinal and/or limb ischemia). Conclusions The consistent and significant association between lactate levels, whether assessed at baseline or during ICU treatment, and the risk of mortality underscores the pivotal prognostic relevance ... |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| العلاقة: | info:eu-repo/semantics/altIdentifier/pmid/38536534; hal-04525267; https://hal.univ-lorraine.fr/hal-04525267Test; https://hal.univ-lorraine.fr/hal-04525267/documentTest; https://hal.univ-lorraine.fr/hal-04525267/file/s13613-024-01266-6.pdfTest; PUBMED: 38536534; PUBMEDCENTRAL: PMC10973308 |
| DOI: | 10.1186/s13613-024-01266-6 |
| الإتاحة: | https://doi.org/10.1186/s13613-024-01266-6Test https://hal.univ-lorraine.fr/hal-04525267Test https://hal.univ-lorraine.fr/hal-04525267/documentTest https://hal.univ-lorraine.fr/hal-04525267/file/s13613-024-01266-6.pdfTest |
| حقوق: | info:eu-repo/semantics/OpenAccess |
| رقم الانضمام: | edsbas.FB25480C |
| قاعدة البيانات: | BASE |
| DOI: | 10.1186/s13613-024-01266-6 |
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