title: Base excess and lactate as prognostic indicators for patients treated by extra corporeal life support after out hospital cardiac arrest due to acute coronary syndrome.
abstract: OBJECTIVE
  To examine whether values of arterial base excess or lactate taken 3 h after starting ECLS indicate poor prognosis and if this can be used as a screening tool to follow Extra Corporeal Life Support after Out Hospital Cardiac Arrest due to acute coronary syndrome.
  
  
  METHODS
  Single Centre retrospective observational study.
  
  
  METHODS
  University teaching hospital general adult intensive care unit.
  
  
  METHODS
  15 consecutive patients admitted to the intensive care unit after refractory Out Hospital Cardiac Arrest due to acute coronary syndrome treated by Extra Corporeal Life Support.
  
  
  METHODS
  Arterial base excess and lactate concentrations were measured immediately after starting ECLS and every 3 h after.
  
  
  RESULTS
  Both base excess and arterial lactate measured 3 h after starting ECLS effectively predict multi-organ failure occurrence and mortality in the following 21 h (area under the curve on receiver operating characteristic analysis of 0.97, 0.95 respectively). The best predictive values were obtained with a base excess level measured 3 h after starting ECLS of less than -10 mmol/l and lactate concentrations greater than 12 mmol/l. The combination of these two markers measured 3 h after starting ECLS predicted multiorgan failure occurrence and mortality in the following 21 h with a sensitivity of 70% and a specificity of 100%.
  
  
  CONCLUSIONS
  Combination of base excess and lactate, measured 3 h after starting ECLS, can be used to predict multiorgan failure occurrence and mortality in the following 21 h in patients admitted to an intensive care unit for refractory Out Hospital Cardiac Arrest due to acute coronary syndrome treated by Extra Corporeal Life Support. These parameters can be obtained simply and rapidly and help in the decision process to continue ECLS for refractory CA.
authors.forename: R
authors.initials: R
authors.lastname: Jouffroy
authors.forename: L
authors.initials: L
authors.lastname: Lamhaut
authors.forename: A
authors.initials: A
authors.lastname: Guyard
authors.forename: P
authors.initials: P
authors.lastname: Phillipe
authors.forename: T
authors.initials: T
authors.lastname: Deluze
authors.forename: M
authors.initials: M
authors.lastname: Jaffry
authors.forename: C
authors.initials: C
authors.lastname: Dagron
authors.forename: W
authors.initials: W
authors.lastname: Bourgoin
authors.forename: J P
authors.initials: JP
authors.lastname: Orsini
authors.forename: K
authors.initials: K
authors.lastname: An
authors.forename: X
authors.initials: X
authors.lastname: Jouven
authors.forename: C
authors.initials: C
authors.lastname: Spaulding
authors.forename: P
authors.initials: P
authors.lastname: Carli
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood / Q000209:etiology / Q000628:therapy*; D011379:Prognosis; D012372:ROC Curve; D012151:Resuscitation / Q000379:methods*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D007773:Lactates