ArticleJournal of the American Heart Association2022
Association Between the Acidemia, Lactic Acidosis, and Shock Severity With Outcomes in Patients With Cardiogenic Shock.
Article in Journal of the American Heart Association, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 41 papers, 2 of them syntheses that pooled it.
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Who cites it
41 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A Systematic Review of Thiamine Supplementation in Improving Diabetes and Its Related Cardiovascular Dysfunction.International journal of molecular sciences · 2025Pooled it
- IMPELLA COMPARED TO VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION IN CARDIOGENIC SHOCK: A SYSTEMATIC REVIEW AND META-ANALYSIS OF PROPENSITY SCORE-MATCHED STUDIES.Shock (Augusta, Ga.) · 2025Pooled it
- Age-related modification of the association between arterial blood pH and intensive care unit mortality: a nationwide retrospective observational study using the Japanese Intensive Care Patient Database (JIPAD).Journal of intensive care · 2026Article
- Article
- Linezolid-induced lactic acidosis in critically ill patients: A multicentre study of incidence, severity and predictors.British journal of clinical pharmacology · 2026Observational
- Acid-Base Status During Venoarterial Extracorporeal Membrane Oxygenator Support in Patients With Cardiogenic Shock.Journal of the American Heart Association · 2026Article
- Diagnostic and Prognostic Value of Arterial Blood Gas and Electrolyte Analyses in Heart Failure.Reviews in cardiovascular medicine · 2026Review
- Acidemia predicts mortality independently of lactate levels in patients after cardiac arrest.Resuscitation plus · 2026Article
- Clinical Evaluation of Microneedle Biosensors for Continuous Lactate Monitoring in Critically Ill Patients.ACS sensors · 2026Article
- Development and validation of an in-hospital cardiogenic shock prediction model for AMI patients based on machine learning.BMC cardiovascular disorders · 2026Article
- Respiratory Support in Cardiogenic Pulmonary Edema: Clinical Insights from Cardiology and Intensive Care.Journal of cardiovascular development and disease · 2026Review
- Lactate/albumin ratio predicts 90-day mortality of cardiogenic shock patients.Open medicine (Warsaw, Poland) · 2026Article
- A miniaturized mouse extracorporeal circulation model to characterize early hematologic and metabolic alterations.Frontiers in physiology · 2026Article
- Phenotyping cardiogenic shock: an insight from the gulf cardiogenic shock registry.Frontiers in artificial intelligence · 2026Article
- Macrovascular Hemodynamics and Peripheral Perfusion in Cardiogenic Shock: Exploring Current Targets and Future Directions.JACC. Advances · 2025Review
- Perspectives on whole body and tissue-specific metabolic flexibility and implications in cardiometabolic diseases.Cell reports. Medicine · 2025Review
- Impact of lactate levels on admission in STEMI patients with cardiogenic shock treated with IMPELLA.Heart and vessels · 2025Observational
- The ADVanced Organ Support (ADVOS) Hemodialysis System in Postoperative Cardiogenic Shock and Multiple Organ Failure: First Results in Cardiac Surgery Patients.Life (Basel, Switzerland) · 2025Article
- Current and novel biomarkers in cardiogenic shock.European journal of heart failure · 2025Review
- Lactate infusion improves cardiac function in a porcine model of ischemic cardiogenic shock.Critical care (London, England) · 2025Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
Background Lactic acidosis is associated with mortality in patients with cardiogenic shock (CS). Elevated lactate levels and systemic acidemia (low blood pH) have both been proposed as drivers of death. We, therefore, analyzed the association of both high lactate concentrations and low blood pH with 30-day mortality in patients with CS. Methods and Results This was a 2-center historical cohort study of unselected patients with CS with available data for admission lactate level or blood pH. CS severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock classification. All-cause survival at 30 days was analyzed using Kaplan-Meier curves and Cox proportional-hazards analysis. There were 1814 patients with CS (mean age, 67.3 years; 68.5% men); 51.8% had myocardial infarction and 53.0% had cardiac arrest. The distribution of SCAI shock stages was B, 10.8%; C, 30.7%; D, 38.1%; and E, 18.7%. In both cohorts, higher lactate or lower pH predicted a higher risk of adjusted 30-day mortality. Patients with a lactate ≥5 mmol/L or pH <7.2 were at increased risk of adjusted 30-day mortality; patients with both lactate ≥5 mmol/L and pH <7.2 had the highest risk of adjusted 30-day mortality. Patients in SCAI shock stages C, D, and E had higher 30-day mortality in each SCAI shock stage if they had lactate ≥5 mmol/L or pH <7.2, particularly if they met both criteria. Conclusions Higher lactate and lower pH predict mortality in patients with cardiogenic shock beyond standard measures of shock severity. Severe lactic acidosis may serve as a risk modifier for the SCAI shock classification. Definitions of refractory or hemometabolic shock should include high lactate levels and low blood pH.
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