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Dynamics of the Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest
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: Received: 24 September 2023 / Approved: 28 September 2023 / Online: 28 September 2023 (02:50:40 CEST)
A peer-reviewed article of this Preprint also exists.
Vujanović, V.; Borovnik Lesjak, V.; Mekiš, D.; Strnad, M. Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest. Medicina 2023, 59, 1989. Vujanović, V.; Borovnik Lesjak, V.; Mekiš, D.; Strnad, M. Dynamics of Capillary Lactate Levels in Patients with Out-of-Hospital Cardiac Arrest. Medicina 2023, 59, 1989.
Abstract
Background and Objectives: Effective strategy to 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 probability of return of spontaneous circulation in out-of-hospital cardiac arrest patients. Materials and Methods: 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 minutes after first measurement until the time of return of spontaneous circulation (ROSC) or if ROSC was not achieved at time of declaring death on scene. Results: 83 patients were enrolled in the study. ROSC was achieved in 28 patients (33,7%), 21 were admitted to the hospital (26,3%) and 6 (7,23%) of them were discharged from the hospital. At discharge all patients had Cerebral Performance Category Scale 1 or 2. Initial capillary lactate values were significantly higher in patients with non-shockable rhythm compared to the group with shockable rhythm (9,19 +/- 4,6 versus 6,43 +/- 3,81; p = 0.037). A significant difference persisted also in a second value taken 10 minutes after in-itial value (10,03 +/- 5,19 versus 5,18 +/- 3,47; p = 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; p = 0,047). Conclusions: Capillary lactate values are significantly lower in patients with a shockable first rhythm in OHCA. There is also a significant connection between a rise in capillary lactate level and ROSC.
Keywords
cardiopulmonary resuscitation, out-of-hospital cardiac arrest, lactate, return of spontaneous circulation
Subject
Medicine and Pharmacology, Emergency Medicine
Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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