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Related Concept Videos

Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
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Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Related Experiment Video

Updated: Apr 30, 2026

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Initial lactate and lactate change in post-cardiac arrest: a multicenter validation study.

Michael W Donnino1, Lars W Andersen, Tyler Giberson

  • 11Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 2Department of Medicine, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA. 3Research Center for Emergency Medicine, Aarhus University, Aarhus, Denmark. 4Department of Emergency Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA. 5Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA. 6Department of Emergency Medicine, University of Pittsburgh, Pittsburgh, PA. 7Department of Anesthesia Critical Care, Division of Critical Care, Beth Israel Deaconess Medical Center, Boston, MA.

Critical Care Medicine
|April 30, 2014
PubMed
Summary

A greater decrease in lactate levels within 12 hours after cardiac arrest is linked to better survival and neurological outcomes in patients. This prospective study validates lactate change as a key indicator for post-cardiac arrest care.

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Area of Science:

  • Critical Care Medicine
  • Cardiology
  • Emergency Medicine

Background:

  • Lactate levels and their rate of change are potential biomarkers in post-cardiac arrest (PCA) patients.
  • Previous studies suggest an association between lactate levels and outcomes, but prospective multicenter validation is lacking.

Purpose of the Study:

  • To prospectively evaluate the association between the percent change in lactate levels and in-hospital mortality and neurological outcomes in PCA patients.
  • To validate lactate change as a prognostic indicator in a multicenter setting.

Main Methods:

  • A prospective, four-center observational study was conducted from June 2011 to March 2012.
  • Included were adult, comatose, out-of-hospital non-traumatic cardiac arrest patients with return of spontaneous circulation.
  • Lactate levels were measured at 0, 12, and 24 hours post-arrest, and percent change was calculated.

Main Results:

  • One hundred patients were analyzed; 46% survived to hospital discharge.
  • Survivors and those with good neurological outcomes had significantly lower lactate levels at all time points (p<0.01).
  • A greater percent decrease in lactate at 12 hours was independently associated with both survival (OR 2.2) and good neurological outcome (OR 2.2).

Conclusions:

  • Lower absolute lactate levels and a greater percent decrease in lactate within the first 12 hours post-cardiac arrest are associated with improved survival and neurological outcomes.
  • Lactate kinetics serve as a valuable prognostic marker in the management of post-cardiac arrest patients.