The predictive value of early arterial lactate clearance rate in cardiogenic shock

Objective To explore the predictive value of early arterial lactate and lactate clearance rate in cardiogenic shock. Methods The study prospectively recruited 94 cardiogenic shock patients who admitted to the department of critical care medicine in Subei People′ Hospital from February 2013 to March 2016. The arterial lactate at the moment of diagnosis of (0 h lactate) and 6 h after diagnosis were reviewed. According to the outcome, patients were divided into survival group (n=55) and non-survival group (n=30). The arterial lactate at 0 h and 6 h and lactate clearance rate in each group were analyzed. The receiver-operating characteristic (ROC) curve was plotted to assess the predictive value of lactate and lactate clearance rate. Results (1)Arterial lactate at 0 h in survival group (3.35±1.03)mmol/L was significantly lower than in non-survival group (4.18±1.39)mmol/L, the difference was statistically significant (t=2.056, P<0.05). Compared with non-survival group (3.43±1.54)mmol/L, arterial lactate at 6 h in survival group were significantly lower (1.98±0.69)mmol/L, the difference was statistically significant (t=4.464, P<0.05). (2)The cut-off value of arterial lactate at 0 h and 6 h was 3.39 mmol/L and 2.32 mmol/L, with sensitivity and specificity both being 80% and 72%, respectively. Furth ermore, the cut-off value of arterial lactate clearance rate was 30.07%, with sensitivity and the specificity being 68% and 67%, respectively. Conclusion Early arterial lactate clearance rate could be an indicator to predict the prognosis in cardiogenic shock patients. Key words: Shock, cardiogenic; Prognosis; Lactate clearance rate