Patterns of oxygen debt repayment in cardiogenic shock patients sustained with extracorporeal life support: A retrospective study

Yuri M Ganushchak*, Eva R Kurniawati, Iwan C C van der Horst, Sander M J van Kuijk, Patrick W Weerwind, Roberto Lorusso, Jos G Maessen

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Cardiogenic shock is the most frequent kind of shock in cardiac intensive care, and cardiac dysfunction and hypoxia are often seen in critically ill patients. Inadequate organ and tissue perfusion and hypoxia result in anaerobic metabolism with hyperlactatemia and oxygen debt accumulation. However, the role of accumulated oxygen debt in the course of cardiogenic shock and hypoxia has not been clearly described. Here, we first described the existence of several patterns of oxygen debt repayment in cardiogenic shock patients maintained by an extracorporeal life support system. Oxygen debt was computed from the lactate concentration at five time points, covering the first 26 h of ECLS. Patterns representing basic pathophysiological processes were independent of the cause of the primary insult. Groups of patients classified into specific patterns differed in terms of survival rate from 51.5% to only 4.6%. It is very important that the initial group not predetermine the fate of the patient and may change in the course of treatment due to 'between-cluster migration'. We believe that our finding of different patterns of oxygen debt repayment in cardiogenic shock patients may offer new insights for a more rational, goal-directed treatment of highly morbid conditions such as hypoxia and cardiogenic shock.

Original languageEnglish
Article number154044
Number of pages7
JournalJournal of Critical Care
Volume71
Early online date21 Apr 2022
DOIs
Publication statusPublished - Oct 2022

Keywords

  • CARDIAC-SURGERY
  • Cardiogenic shock
  • Extracorporeal life support
  • LACTATE
  • MANAGEMENT
  • MECHANICAL CIRCULATORY SUPPORT
  • METABOLIC ACIDEMIA
  • MORTALITY
  • Oxygen debt
  • Oxygen debt repayment schedule
  • PREDICTORS
  • RESUSCITATION
  • SEVERITY
  • STRATEGIES

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