ArticleResuscitation2023
Serum lactate in refractory out-of-hospital cardiac arrest: Post-hoc analysis of the Prague OHCA study.
Article in Resuscitation, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01511666 (Hyperinvasive Approach to out-of Hospital Cardiac Arrest Using Mechanical Chest Compression Device, Prehospital Intraarrest Cooling, Extracorporeal Life Support and Early Invasive Assessment Compared to Standard of Care. A Randomized Parallel Groups Comparative Study. "Prague OHCA Study"), which is not on this map. Cited by 20 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Hyperinvasive Approach to out-of Hospital Cardiac Arrest Using Mechanical Chest Compression Device, Prehospital Intraarrest Cooling, Extracorporeal Life Support and Early Invasive Assessment Compared to Standard of Care. A Randomized Parallel Groups Comparative Study. "Prague OHCA Study"
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Part 4: Systems of Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- External validation and comparative performance of ACLS, SARICA, NULL-PLEASE, BDR scores for in-hospital mortality after out-of-hospital cardiac arrest: a multicenter retrospective cohort study.Resuscitation plus · 2026Article
- Impact of transient return of spontaneous circulation and downtime on neurological outcomes following extracorporeal cardiopulmonary resuscitation for refractory out-of-hospital cardiac arrest: a single-center retrospective study.BMC cardiovascular disorders · 2026Article
- Nucleated red blood cells as early predictors of poor neurological outcome after extracorporeal cardiopulmonary resuscitation: a retrospective dual-site cohort study of early laboratory markers.Resuscitation plus · 2026Article
- Retrospective Cohort Analysis of TyG, TyG-SI, and TyG-Lac Indices as Predictors of 360-Day Mortality in Critically Ill Ischemic Stroke Patients.Journal of clinical medicine · 2026Article
- Prehospital prediction of survival after out-of-hospital cardiac arrest using point-of-care testing and vital signs: a prospective, multinational study.Scientific reports · 2026Article
- Outcomes and implications of patients included vs excluded for extracorporeal cardiopulmonary resuscitation after initial activation.Resuscitation plus · 2026Article
- Survival Prediction for Non-Asphyxia-Related Hypothermic Cardiac Arrest Patients After Extracorporeal Rewarming: Development of the HELP Score.ASAIO journal (American Society for Artificial Internal Organs : 1992) · 2026Article
- Impact of extended eligibility criteria on survival after veno-arterial extracorporeal membrane oxygenation for refractory cardiac arrest: a 8-year single-center study.Resuscitation plus · 2025Article
- Lactate and pH as Independent Biomarkers for Prognosticating Meaningful Post-out-of-Hospital Cardiac Arrest Outcomes: A Systematic Review and Meta-Analysis.Journal of clinical medicine · 2025Review
- Early Risk Stratification of Patients After Successfully Resuscitated Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation-The Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation (TOMAHAWK) Risk Score.Critical care explorations · 2025Article
- Clinical Outcomes of Out-of-Hospital Cardiac Arrest with ROSC: Insights from a Specialized Referral Center in Vietnam.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2025Article
- Novel prehospital lactate cut-off estimation for mortality: a multicentre observational study.BMJ open · 2024Observational
- Neuron-Specific Enolase as a Predictor of Neurologic Outcomes in Extracorporeal Cardiopulmonary Resuscitation Patients.Journal of clinical medicine · 2024Article
- Physiology-Guided Resuscitation: Monitoring and Augmenting Perfusion during Cardiopulmonary Arrest.Journal of clinical medicine · 2024Review
- Favorable resuscitation characteristics in patients undergoing extracorporeal cardiopulmonary resuscitation: A secondary analysis of the INCEPTION-trial.Resuscitation plus · 2024Article
- [Extracorporeal life support (ECLS)-update 2023].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2024Article
- Wolf Creek XVII Part 8: Neuroprotection.Resuscitation plus · 2024Review
- Article
- How confidently can we prognosticate survival when starting ECPR?Resuscitation · 2023Article
Corrections and comments
- Commented on by
Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe severity of tissue hypoxia is routinely assessed by serum lactate. We aimed to determine whether early lactate levels predict outcomes in refractory out-of-hospital cardiac arrest (OHCA) treated by conventional and extracorporeal cardiopulmonary resuscitation (ECPR).
methodsThis study is a post-hoc analysis of a randomized Prague OHCA study (NCT01511666) assessing serum lactate levels in refractory OHCA treated by ECPR (the ECPR group) or conventional resuscitation with prehospital achieved return of spontaneous circulation (the ROSC group). Lactate concentrations measured on admission and every 4 hours (h) during the first 24 h were used to determine their relationship with the neurological outcome (the best Cerebral Performance Category score within 180 days post-cardiac arrest).
resultsIn the ECPR group (92 patients, median age 58.5 years, 83% male) 26% attained a favorable neurological outcome. In the ROSC group (82 patients, median age 55 years, 83% male) 59% achieved a favorable neurological outcome. In ECPR patients lactate concentrations could discriminate favorable outcome patients, but not consistently in the ROSC group. On admission, serum lactate >14.0 mmol/L for ECPR (specificity 87.5%, sensitivity 54.4%) and >10.8 mmol/L for the ROSC group (specificity 83%, sensitivity 41.2%) predicted an unfavorable outcome.
conclusionIn refractory OHCA serum lactate concentrations measured anytime during the first 24 h after admission to the hospital were found to correlate with the outcome in patients treated by ECPR but not in patients with prehospital ROSC. A single lactate measurement is not enough for a reliable outcome prediction and cannot be used alone to guide treatment.
Indexed as
Identifiers
37574002What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.