Lonsain et al reported the correlation between lactate clearance and survival after a cardiac arrest. This can help to identify a patient who may have a better prognosis. The authors are from University Hospitals of Leuven in Belgium.
Patient selection: adult with out-of-hospital cardiac arrest
Outcome: various measures of survival
Parameters:
(1) arterial serum lactate on admission to hospital after ROSC in mmol/L
(2) arterial serum lactate 3 hours later
lactate clearance =
= ((lactate at ROSC) - (lactate at 3 hours)) / (lactate at ROSC) * 100
The lactate concentration in arterial blood is lower than in venous blood.
Lactate clearance at 3 hours after the return of spontaneous circulation (ROSC) correlated with 24-hour survival as well as survival to 48 and 72 hours. The higher the clearance the better the survival. The median clearance was 53.6% in 24-hour survivors and 28.1% in 24-hour nonsurvivors.
The area under the ROC curve for 24-hour survival was 0.75.
Survival at 1 month, 3 months and 1 year was primarily predicted by the initial rhythm.
• Shockable rhythm: pulseless ventricular tachycardia, ventricular fibrillation
• Non-shockable rhythm: asystole or pulseless electrical activity (PEA)
