title: Correlation between initial serum levels of lactate after return of spontaneous circulation and survival and neurological outcomes in patients who undergo therapeutic hypothermia after cardiac arrest.
abstract: OBJECTIVE
  We analysed the relationship between serum levels of lactate within 1h of return of spontaneous circulation (ROSC) and survival and neurological outcomes in patients who underwent therapeutic hypothermia (TH).
  
  
  METHODS
  This was a multi-centre retrospective and observational study that examined data from the first Korean Hypothermia Network (KORHN) registry from 2007 to 2012. The inclusion criteria were out-of-hospital cardiac arrest (OHCA) and examination of serum levels of lactate within 1h after ROSC, taken from KORHN registry data. The primary endpoint was survival outcome at hospital discharge, and the secondary endpoint was poor neurological outcome (Cerebral Performance Category, CPC, 3-5) at hospital discharge. Initial lactate levels and other variables collected within 1h of ROSC were analysed via multivariable logistic regression.
  
  
  RESULTS
  Data from 930 cardiac arrest patients who underwent TH were collected from the KORHN registry. In a total of 443 patients, serum levels of lactate were examined within 1h of ROSC. In-hospital mortality was 289/443 (65.24%), and 347/443 (78.33%) of the patients had CPCs of 3-5 upon hospital discharge. The odds ratios of lactate levels for CPC and in-hospital mortality were 1.072 (95% confidence interval (CI) 1.026-1.121) and 1.087 (95% CI=1.031-1.147), respectively, based on multivariate ordinal logistic regression analyses.
  
  
  CONCLUSIONS
  High levels of lactate in serum measured within 1h of ROSC are associated with hospital mortality and high CPC scores in cardiac arrest patients treated with TH.
authors.affiliation: Department of Emergency Medicine, College of Medicine, Chung-Ang University, Seoul, Republic of Korea. Electronic address: emdhlee@cau.ac.kr.
authors.forename: Dong Hoon
authors.initials: DH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, KEPCO Medical Center, Seoul, Republic of Korea. Electronic address: mensa@hanmail.net.
authors.forename: In Soo
authors.initials: IS
authors.lastname: Cho
authors.affiliation: Department of Emergency Medicine, Ewha Womans University, Seoul, Republic of Korea. Electronic address: sunhwa9@hanmail.net.
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Emergency Medicine, Chonnam National University, Gwangju, Republic of Korea. Electronic address: minyi46@hanmail.net.
authors.forename: Yong Il
authors.initials: YI
authors.lastname: Min
authors.affiliation: Department of Emergency Medicine, College of Medicine Chungbuk National University, Cheongju-si, Republic of Korea. Electronic address: shiphid@hanmail.net.
authors.forename: Jin Hong
authors.initials: JH
authors.lastname: Min
authors.affiliation: Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: emksh77@gmail.com.
authors.forename: Soo Hyun
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Departments of Emergency Medicine, Hallym University Sacred Heart Hospital, Anyang-si, Republic of Korea. Electronic address: Hwaniyo@naver.com.
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D016887:Cardiopulmonary Resuscitation / Q000379:methods*; D005260:Female; D006439:Hemodynamics / Q000502:physiology*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D020127:Recovery of Function; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D019344:Lactic Acid
keywords: Cardiac arrest; Lactate; Outcome; Therapeutic hypothermia