Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest
<i>Background and Objectives</i>: An effective strategy for cardiopulmonary resuscitation should be based on tissue perfusion. Our primary aim was to determine the association between capillary lactate values and initial rhythm as well as the probability of the return of spontaneous circ...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-11-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/59/11/1989 |
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| author | Vitka Vujanović Vesna Borovnik Lesjak Dušan Mekiš Matej Strnad |
| author_facet | Vitka Vujanović Vesna Borovnik Lesjak Dušan Mekiš Matej Strnad |
| author_sort | Vitka Vujanović |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: An effective strategy for cardiopulmonary resuscitation should be based on tissue perfusion. Our primary aim was to determine the association between capillary lactate values and initial rhythm as well as the probability of the return of spontaneous circulation in out-of-hospital cardiac arrest patients. <i>Materials and Methods</i>: This prospective observational cohort study included all patients with non-traumatic out-of-hospital cardiac arrest, older than 18 years, resuscitated by a prehospital emergency medical team between April 2020 and June 2021. Capillary lactate samples were collected at the time of arrival and every 10 min after the first measurement until the time of the return of spontaneous circulation (ROSC) or, if ROSC was not achieved, at the time of declaring death on the scene. <i>Results</i>: In total, 83 patients were enrolled in the study. ROSC was achieved in 28 patients (33.7%), 21 were admitted to hospital (26.3%), and 6 (7.23%) of them were discharged from hospital. At discharge, all patients had Cerebral Performance Category Scale 1 or 2. Initial capillary lactate values were significantly higher in patients with a non-shockable rhythm compared to the group with a shockable rhythm (9.19 ± 4.6 versus 6.43 ± 3.81; <i>p</i> = 0.037). A significant difference also persisted in a second value taken 10 min after the initial value (10.03 ± 5,19 versus 5.18 ± 3.47; <i>p</i> = 0.019). Capillary lactate values were higher in the ROSC group and non-ROSC group at the time of restored circulation (11.10 ± 6.59 and 6.77 ± 4.23, respectively; <i>p</i> = 0.047). <i>Conclusions</i>: Capillary lactate values are significantly higher in patients with a non-shockable first rhythm in out-of-hospital cardiac arrest (OHCA). There is also a significantly different rise in capillary lactate levels in patients with ROSC. |
| first_indexed | 2024-03-09T16:38:40Z |
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| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T16:38:40Z |
| publishDate | 2023-11-01 |
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| record_format | Article |
| series | Medicina |
| spelling | doaj.art-e2fa813c7036465da16f450acd94171c2023-11-24T14:54:56ZengMDPI AGMedicina1010-660X1648-91442023-11-015911198910.3390/medicina59111989Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac ArrestVitka Vujanović0Vesna Borovnik Lesjak1Dušan Mekiš2Matej Strnad3Center for Emergency Medicine, Prehospital Unit, Community Healthcare Center, Cesta Proletarskih Brigad 21, 2000 Maribor, SloveniaCenter for Emergency Medicine, Prehospital Unit, Community Healthcare Center, Cesta Proletarskih Brigad 21, 2000 Maribor, SloveniaDepartment of Anaesthesiology, Intensive Care and Pain Management, University Clinical Centre Maribor, Ljubljanska ul. 5, 2000 Maribor, SloveniaCenter for Emergency Medicine, Prehospital Unit, Community Healthcare Center, Cesta Proletarskih Brigad 21, 2000 Maribor, Slovenia<i>Background and Objectives</i>: An effective strategy for cardiopulmonary resuscitation should be based on tissue perfusion. Our primary aim was to determine the association between capillary lactate values and initial rhythm as well as the probability of the return of spontaneous circulation in out-of-hospital cardiac arrest patients. <i>Materials and Methods</i>: This prospective observational cohort study included all patients with non-traumatic out-of-hospital cardiac arrest, older than 18 years, resuscitated by a prehospital emergency medical team between April 2020 and June 2021. Capillary lactate samples were collected at the time of arrival and every 10 min after the first measurement until the time of the return of spontaneous circulation (ROSC) or, if ROSC was not achieved, at the time of declaring death on the scene. <i>Results</i>: In total, 83 patients were enrolled in the study. ROSC was achieved in 28 patients (33.7%), 21 were admitted to hospital (26.3%), and 6 (7.23%) of them were discharged from hospital. At discharge, all patients had Cerebral Performance Category Scale 1 or 2. Initial capillary lactate values were significantly higher in patients with a non-shockable rhythm compared to the group with a shockable rhythm (9.19 ± 4.6 versus 6.43 ± 3.81; <i>p</i> = 0.037). A significant difference also persisted in a second value taken 10 min after the initial value (10.03 ± 5,19 versus 5.18 ± 3.47; <i>p</i> = 0.019). Capillary lactate values were higher in the ROSC group and non-ROSC group at the time of restored circulation (11.10 ± 6.59 and 6.77 ± 4.23, respectively; <i>p</i> = 0.047). <i>Conclusions</i>: Capillary lactate values are significantly higher in patients with a non-shockable first rhythm in out-of-hospital cardiac arrest (OHCA). There is also a significantly different rise in capillary lactate levels in patients with ROSC.https://www.mdpi.com/1648-9144/59/11/1989cardiopulmonary resuscitationout-of-hospital cardiac arrestlactatereturn of spontaneous circulation |
| spellingShingle | Vitka Vujanović Vesna Borovnik Lesjak Dušan Mekiš Matej Strnad Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest Medicina cardiopulmonary resuscitation out-of-hospital cardiac arrest lactate return of spontaneous circulation |
| title | Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest |
| title_full | Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest |
| title_fullStr | Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest |
| title_full_unstemmed | Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest |
| title_short | Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest |
| title_sort | dynamics of capillary lactate levels in patients with out of hospital cardiac arrest |
| topic | cardiopulmonary resuscitation out-of-hospital cardiac arrest lactate return of spontaneous circulation |
| url | https://www.mdpi.com/1648-9144/59/11/1989 |
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