Related Experiment Video
Updated: Mar 5, 2026
Postconditioning with Lactate-enriched Blood for Cardioprotection in ST-segment Elevation Myocardial Infarction
Published on: May 28, 2019
Early Lactate Clearance Is Associated With Improved Outcomes in Patients With Postcardiac Arrest Syndrome: A
Kei Hayashida1, Masaru Suzuki, Naohiro Yonemoto
11Department of Emergency and Critical Care Medicine, School of Medicine, Keio University, Tokyo, Japan.2Department of Anesthesia, Critical Care & Pain Medicine, Massachusetts General Hospital/Harvard Medical School, Charlestown, MA.3Department of Biostatistics, School of Public Health, Kyoto University, Yoshida-konoe, Kyoto, Japan.4Division of Emergency and Critical Care Medicine, Department of Acute Medicine, Nihon University School of Medicine, Itabashi-ku, Tokyo, Japan.5Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Hospital, Suita, Osaka, Japan.6Cardiovascular Center, Nihon University Surugadai Hospital, Chiyoda-ku, Tokyo, Japan.7Department of Critical Care and Emergency Medicine, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.8Department of Emergency Medicine, Yokohama City University Medical Center, Yokohama-City, Kanagawa, Japan.
Objectives:
To determine whether early lactate reduction is associated with improved survival and good neurologic outcome in patients with out-of-hospital cardiac arrest.
Design:
Ad hoc data analysis of a prospective, multicenter observational study.
Setting:
Out-of-hospital cardiac arrest patients at 67 emergency hospitals in Kanto, Japan between January 2012 and March 2013.
Patients:
Adult patients with out-of-hospital cardiac arrest admitted to the hospital after successful resuscitation were identified.
Interventions:
Blood lactate concentrations were measured at hospital admission and 6 h after hospital admission. Early lactate clearance was defined as the percent change in lactate level 6 h after a baseline measurement.
Measurements And Main Results:
The 543 patients (mean age, 65 ± 16 yr; 72.6% male) had a mean lactate clearance of 42.4% ± 53.7%. Overall 30-day survival and good neurologic outcome were 47.1% and 27.4%, respectively. The survival proportion increased with increasing lactate clearance (quartile 1, 29.4%; quartile 2, 42.6%; quartile 3, 51.5%; quartile 4, 65.2%; p < 0.001). Multivariate logistic regression analysis showed that lactate clearance quartile was an independent predictor of the 30-day survival and good neurologic outcome. In the Cox proportional hazards model, the frequency of mortality during 30 days was significantly higher for patients with lactate clearance in quartile 1 (hazard ratio, 3.12; 95% CI, 2.14-4.53), quartile 2 (hazard ratio, 2.13; 95% CI, 1.46-3.11), and quartile 3 (hazard ratio, 1.49; 95% CI, 1.01-2.19) than those with lactate clearance in quartile 4. Furthermore, multivariate logistic regression analysis revealed that lactate clearance was a significant predictor of good neurologic outcome at 30 days after hospital admission.
Conclusions:
Effective lactate reduction over the first 6 hours of postcardiac arrest care was associated with survival and good neurologic outcome independently of the initial lactate level.
More Related Videos
08:19Transthoracic Echocardiography to Assess Post-Resuscitation Left Ventricular Dysfunction After Acute Myocardial Infarction and Cardiac Arrest in Pigs
Published on: July 12, 2022
05:36Standardized Model of Ventricular Fibrillation and Advanced Cardiac Life Support in Swine
Published on: January 30, 2020
Related Concept Videos
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:24Muscle Recovery and Fatigue
01:22Cardiopulmonary Resuscitation II: ACLS Airway Management
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...