Lactate and Lactate Clearance as Predictors of One-Year Survival in Extracorporeal Cardiopulmonary Resuscitation – An International, Multicentre Cohort Study

Cardiac arrest is the third leading cause of mortality in Europe.[1] Survival after out-of-hospital cardiac arrest (OHCA) is dismal. The survival rate ranges from 8 to 14%.[2] In selected cases of cardiac arrest refractory to conventional cardiopulmonary resuscitation (CPR), the use of extracorporeal CPR (ECPR) with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has recently shown conflicting results in randomised controlled trials (RCT).[3 –5] These conflicting results might be due to multiple differences in study design (single-centre [ARREST and Prague OHCA study] versus multi-centre [INCEPTION], enrolment period and study size (14 ECPR patients within one year [ARREST] versus 124 ECPR patients between 2013 and 2020 [Prague OHCA s tudy] versus 70 ECPR patients between 2017 and 2021 [INCEPTION]), patient selection (initial ECG rhythm: shockable [ARREST and INCEPTION] versus any rhythm [Prague OHCA study], witnessed cardiac arrest [Prague OHCA study and INCEPTION]), ECPR organisation (randomisation time: at hospital arrival [AR REST] versus on scene [Prague OHCA study] versus during transport [INCEPTION]), blinding of emergency medical service [ARREST and INCEPTION], location of ECMO cannulation (catheterisation laboratory [ARREST and Prague OHCA study] versus emergency department [INCEPTION]) and outcomes (in-hospital sur vival [ARREST] versus 180-day survival with favourable neurological status [OHCA Prague study] versus 30-day survival with favourable neuro...
Source: Resuscitation - Category: Emergency Medicine Authors: Tags: Clinical paper Source Type: research