ArticleAnnals of intensive care2024
Serial daily lactate levels association with 30-day outcome in cardiogenic shock patients treated with VA-ECMO: a post-hoc analysis of the HYPO-ECMO study.
Article in Annals of intensive care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02754193 (Effects of Induced Moderate HYPOthermia on Mortality in Cardiogenic Shock Patients Rescued by Veno-arterial ExtraCorporeal Membrane Oxygenation), which is not on this map. Cited by 16 papers.
What it found
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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.
Effects of Induced Moderate HYPOthermia on Mortality in Cardiogenic Shock Patients Rescued by Veno-arterial ExtraCorporeal Membrane Oxygenation (ECMO)
Who cites it
16 citing papers in PubMed, 15 citations in OpenAlex.
- Mitigating limb ischemia in veno-arterial extracorporeal membrane oxygenation: A narrative review of evolving role of distal perfusion catheters.World journal of critical care medicine · 2026Review
- Beyond the Pump: Unravelling Immunometabolic Crosstalk and Organelle Dynamics in Sepsis-Induced Cardiomyopathy.Journal of cardiovascular translational research · 2026Article
- Microcirculation and Cerebrovascular Autoregulation in Patients With Mechanical Circulatory Support Devices.Journal of stroke · 2026Review
- 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
- Article
- Serial Lactate in Clinical Medicine - A Narrative Review.Journal of intensive care medicine · 2026Review
- Biomarkers of multi-organ dysfunction in ECMO: prognostic signposts for palliative transitions.Frontiers in medicine · 2026Review
- Lactate in cardiogenic shock: pathophysiology, prognostic value, and clinical interpretation.Annals of intensive care · 2026Review
- A Clinical and Biomarker-Based Model for Predicting in-Hospital Mortality in Patients Undergoing Extracorporeal Membrane Oxygenation: A Machine Learning-Based Nomogram Study.Journal of inflammation research · 2026Article
- Intraoperative peak lactate as a predictor of in-hospital mortality following non-cardiac emergency surgery: a retrospective cohort study.Langenbeck's archives of surgery · 2025Observational
- Clinical Features and Mortality of ICU Patients with Thyroid Storm Receiving Extracorporeal Membrane Oxygenation: A Single-Center Experience in Taiwan.Acta Cardiologica Sinica · 2025Article
- Lactate dynamics as a marker of perfusion: physiological interpretation and pitfalls.Intensive care medicine · 2025Article
- Observational
- Management of cardiogenic shock: state-of-the-art.Intensive care medicine · 2024Review
- Biomarkers in cardiogenic shock: old pals, new friends.Annals of intensive care · 2024Review
- Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundReliable predictors of outcomes in venoarterial extracorporeal membrane oxygenation (VA-ECMO) therapy are limited. While elevated lactate levels over time have been linked to outcomes in cardiogenic shock (CS), their significance in VA-ECMO-treated patients remains inconclusive.
methodsWe conducted a post hoc analysis of data from the HYPO-ECMO trial, which compared normothermia to moderate hypothermia in CS patients supported by VA-ECMO. We examined daily lactate levels collected over a week to assess their correlation with 30-day mortality.
resultsAmong the 318 out of 334 patients (95%) with baseline lactate measurements, 66 had normal levels (< 2.2 mmol/l, 21%). No difference was found in lactate course between moderate hypothermia and normothermia groups. Lactate levels were consistently higher in non-survivors at each time point (p = 0.0002). Baseline hyperlactatemia was associated with an increased risk of death (Hazard Ratio [HR]: 1.85 (1.12-3.05), p = 0.016). When considering all time points, lactate levels during the ICU stay were significantly and gradually associated with a higher risk of death (p < 0.0001). In the overall population, a decrease in lactate levels was not linked to 30-day mortality. However, patients with baseline hyperlactatemia exhibited a more significant decrease in lactate levels from day one to seven (p < 0.0001). In this group, survivors had a significantly greater decrease in lactate levels at day 1 compared to non-survivors (63% (48-77) versus 57% (21-75), p = 0.026). Patients experiencing a secondary increase in lactate (24%) had a worse prognosis (Hazard Ratio: 1.78 (1.21-2.61), p = 0.004), regardless of both baseline lactate levels and the occurrence of severe ischemic adverse events (intestinal and/or limb ischemia).
conclusionsThe consistent and significant association between lactate levels, whether assessed at baseline or during ICU treatment, and the risk of mortality underscores the pivotal prognostic relevance of lactate levels in patients with CS undergoing VA-ECMO therapy. The study findings provide some novel insights, regarding the trend profile and the relevance of a second peak during the 7 day period after ECMO start. Trial Registration identifier NCT02754193 registered on 2016-04-12.
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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.