Department of Emergency Medicine, Beijing Tongren Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory of Cardiopulmonary Cerebral Resuscitation, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Am J Emerg Med. 2018 Nov;36(11):2020-2028. doi: 10.1016/j.ajem.2018.03.015. Epub 2018 Mar 10.
Recently, a series of studies have been conducted to investigate the association of the common biochemical biomarkers, such as serum lactate and creatinine, with clinical outcomes in cardiac arrest patients treated with extracorporeal membrane oxygenation (ECMO), however, the results were not consistent and the sample size of primary studies is limited. In the present study, we performed a systematic review and meta-analysis to summarize the associations.
Relevant studies in English databases (PubMed, ISI web of science, and Embase) and Chinese databases (Wanfang and CNKI) up to January 2018 were systematically searched. Crude ORs or HRs from the included studies were extracted and pooled to summarize the associations of lactate and creatinine with clinical outcomes including survival and neurological outcomes in ECMO treated cardiac arrest patients.
17 papers containing 903 cases were included in the present meta-analysis study. After pooling all the eligible studies, we identified the significant associations of high lactate level with poor survival (N=13, OR=1.335, 95%CI=1.167-1.527, P<0.001) and poor neurological outcome (N=2, HR=1.058, 95%CI=1.020-1.098, P=0.002) in CA patients treated with ECMO and a slight significant association of high creatinine with poor survival was also found (N=7, OR=1.010, 95%CI=1.002-1.018, P=0.015).
High serum lactate level was associated with poor survival and poor neurological outcome in CA patients treated with ECMO. Further well-designed studies with larger sample size should be conducted to confirm the results.
最近，一系列研究调查了常见生化标志物（如血清乳酸和肌酐）与接受体外膜氧合（ECMO）治疗的心脏骤停患者临床结局的相关性，但结果并不一致，且初步研究的样本量有限。本研究旨在进行系统评价和荟萃分析以总结相关性。
系统检索英文数据库（PubMed、ISI web of science 和 Embase）和中文数据库（万方和中国知网）截至 2018 年 1 月的相关研究。提取纳入研究中的原始 OR 或 HR，并进行汇总以总结乳酸和肌酐与 ECMO 治疗心脏骤停患者的临床结局（包括存活率和神经结局）的相关性。
本荟萃分析纳入了 17 篇文献共 903 例患者。综合所有纳入的研究，我们发现高乳酸水平与存活率差（N=13，OR=1.335，95%CI=1.167-1.527，P<0.001）和神经结局差（N=2，HR=1.058，95%CI=1.020-1.098，P=0.002）显著相关，且高肌酐水平与存活率差也有轻微显著相关性（N=7，OR=1.010，95%CI=1.002-1.018，P=0.015）。
血清乳酸水平升高与 ECMO 治疗的心脏骤停患者存活率和神经结局差相关。应开展进一步的设计合理、样本量更大的研究以确认结果。
