Lactate Levels May Predict Prognosis in Comatose Post-Cardiac Arrest Patients

Although guidelines recommend serial lactate measurements to assess perfusion in critically ill patients, data to support this approach are derived mainly from burn, trauma, and septic patients and not from post-cardiac arrest populations. Using data from a four-hospital cardiac arrest research consortium, investigators studied the association between lactate changes and outcomes in 100 adults with out-of-hospital cardiac arrest who remained comatose after return of spontaneous circulation. Forty-six patients survived to hospital discharge, of whom 30 had good neurologic outcomes.

Median lactate levels at 0, 12, and 24 hours were significantly lower in survivors than in nonsurvivors and in patients with good neurologic outcomes than in those…