Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Prause, G; Ratzenhofer-Comenda, B; Smolle-Jüttner, F; Heydar-Fadai, J; Wildner, G; Spernbauer, P; Smolle, J; Hetz, H.
Comparison of lactate or BE during out-of-hospital cardiac arrest to determine metabolic acidosis.
Resuscitation. 2001; 51(3):297-300
Doi: 10.1016/S0300-9572(01)00424-5
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- Führende Autor*innen der Med Uni Graz
- Prause Gerhard
- Co-Autor*innen der Med Uni Graz
- Ratzenhofer-Komenda Beatrice
- Smolle Josef
- Smolle-Juettner Freyja-Maria
- Wildner Gernot
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- Abstract:
- During cardiopulmonary resuscitation, pH and base excess (BE) decrease to a variable degree due to metabolic acidosis. The main cause has been shown to be lactate, which cannot be eliminated sufficiently because of low perfusion during cardiac massage. Both BE and lactate can be measured in the prehospital phase. The aim of the study was to determine if BE and lactate are comparable variables during cardiopulmonary resuscitation (CPR) and if the measurement of lactate level alone would be sufficient to determine the patient's metabolic status and sufficiently reliable to determine the administration of buffer solutions. During the observation period, we registered 31 patients (21 males, ten females) who were resuscitated according to European Resuscitation Council recommendations, who had blood gas analysis and lactate levels measured in blood taken by arterial puncture or arterial line. The first measurement from each patient was taken after primary resuscitation (within 5-20 min). The mean lactate level was 9.85+/-2.98 (range, 4.1-18.7) mmol/l, and the mean BE was -15.0+/-5.98 (range, 5.5 to -24.3). There were statistically significant correlations between the lactate level and BE and pH (linear correlation, r=-0.673, P<0,001 and r=-0,683, P<0,001, respectively), but not with pO2 and pCO2. The receiver-operated curve analysis showed that a cut-off point of 7.0 mmol/l lactate indicates a BE below -10 with a sensitivity of 96% and a specificity of 67%. Lactate measurement is a valuable tool to determine metabolic acidosis during CPR and may be able to replace blood gas analysis in this situation.
- Find related publications in this database (using NLM MeSH Indexing)
- Acidosis - diagnosis
- Aged -
- Blood Gas Analysis -
- Cardiopulmonary Resuscitation -
- Female -
- Heart Arrest - metabolism
- Humans -
- Lactic Acid - blood
- Male -
- ROC Curve -
- Sensitivity and Specificity -
- Find related publications in this database (Keywords)
- blood gases
- bicarbonate
- lactate
- cardiopulmonary resuscitation