Targeted temperature management guided by the severity of hyperlactatemia for out-of-hospital cardiac arrest patients: a post hoc analysis of a nationwide, multicenter prospective registry

Okazaki, Tomoya; Hifumi, Toru; Kawakita, Kenya; Kuroda, Yasuhiro

doi:10.1186/s13613-019-0603-y

Annals of Intensive Care

Table 2 Comparison between three hyperlactatemia groups

From: Targeted temperature management guided by the severity of hyperlactatemia for out-of-hospital cardiac arrest patients: a post hoc analysis of a nationwide, multicenter prospective registry

Variables	Hyperlactatemia classification			p value
Variables	Mild n = 139	Moderate n = 182	Severe n = 114	p value
Age, years	64 [52, 73]	64 [50, 75]	60 [48, 68]	0.087
Age > 65 years	63 (45)	81 (45)	38 (33)	0.098
Male sex	105 (76)	143 (79)	90 (79)	0.757
Witness	118 (85)	149 (82)	81 (71)	0.017
Dispatcher instruction	66 (47)	89 (49)	43 (38)	0.149
Bystander-performed CPR	77 (55)	100 (55)	51 (45)	0.161
Cardiac etiology	115 (83)	135 (74)	82 (72)	0.089
Initial shockable rhythm	88 (63)	100 (55)	47 (41)	0.002
Prehospital epinephrine administration	21 (15)	41 (23)	37 (32)	0.005
Prehospital advanced airway management	33 (24)	61 (34)	51 (45)	0.002
Prehospital AED	114 (82)	132 (73)	67 (59)	< 0.001
Response time, min	8 [6, 9]	8 [6, 9]	8 [7, 9]	0.376
Time from call to hospital arrival, min	32 [25, 39]	30 [24, 35]	29 [24, 37]	0.200
Prehospital ROSC	102 (73)	112 (62)	38 (33)	< 0.001
Glasgow Coma Scale score	3 [3, 4]	3 [3, 3]	3 [3, 3]	< 0.001
Coronary angiography	85 (61)	106 (58)	66 (58)	0.833
ECMO and/or IABP	45 (32)	37 (20)	41 (36)	0.006
Door-to-first ABG measurement after ROSC, min	11 [5, 30]	9 [5, 18]	15 [7, 30]	0.007
pH	7.28 [7.22, 7.33]	7.12 [7.02, 7.28]	6.92 [6.75, 7.03]	< 0.001
PaCO₂, mm Hg	43 [37, 51]	52 [35, 75]	70 [43, 97]	< 0.001
PaCO₂ 30–50 mm Hg	90 (65)	63 (35)	27 (24)	< 0.001
PaO₂, mm Hg	176 [91, 337]	187 [92, 356]	150 [79, 346]	0.760
HCO₃, mmol/l	19.9 [17.1, 21.7]	16.4 [13.9, 18.6]	12.9 [10.3, 16.8]	< 0.001
Base excess, mmol/l	− 6.2 [− 9.1, − 4.0]	− 12 [− 14.7, − 9.5]	− 19.4 [− 24.1, − 15.4]	< 0.001
Lactate value, mmol/l	5.2 [3.7, 6.1]	9.1 [7.9, 10.2]	14.9 [13.2, 18.0]	< 0.001
Door-to-TTM initiation, min	106 [30, 188]	115 [36, 190]	136 [46, 225]	0.324
Targeted temperature management				0.331
32–34 °C	108 (78)	128 (70)	83 (73)
35–36 °C	31 (22)	54 (30)	31 (27)
30-day favorable neurological outcome	84 (60)	76 (42)	22 (19)	< 0.001
30-day survival	117 (84)	144 (79)	64 (56)	< 0.001

Continuous variables were presented as median [Interquartile range]. Categorical variables were presented as n (%)
CPR cardiopulmonary resuscitation, AED automated external defibrillator, ROSC return of spontaneous circulation, ECMO extracorporeal membrane oxygenation, IABP intra-aortic balloon pumping, ABG arterial blood gas

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