Paramedic PapersHome Cardiac arrest Lactate after paediatric OHCA predicts outcome
Cardiac arrest
Lactate after paediatric OHCA predicts outcome
Association of serum lactate with outcome after pediatric out-of-hospital cardiac arrest: a secondary analysis of the Therapeutic Hypothermia After Pediatric Cardiac Arrest (THAPCA) trial
Resuscitation · Added 25 August 2026
Secondary analysis of 213 pediatric OHCA patients found higher lactate within 6 hours of ROSC was associated with unfavorable 12-month neurobehavioral outcomes (median 7.8 vs 3.1 mmol/L), with each 1 mmol/L increase increasing odds of unfavorable outcome by 40%.
- Study type
- Cohort
- Design
- Secondary analysis of the THAPCA-OH randomised trial
- Participants
- 213 children with OHCA
- Main finding
- Median first lactate within 6 h of ROSC was 7.8 vs 3.1 mmol/L for unfavourable vs favourable 12-month outcome; each 1 mmol/L increase raised odds of unfavourable outcome 1.40-fold (95% CI 1.17–1.69)
- Caveat
- Secondary analysis of trial population; association, not validated as a prognostic tool
- Bottom line
- Context only
Why it matters in Australia (Medium relevance). Pediatric OHCA prognostication — limited direct prehospital application but valuable for understanding long-term outcomes
Learning goal
Strengthen my interpretation of early post-ROSC lactate when communicating prognosis in paediatric cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 25 August 2026
Related papers on Cardiac arrest
-
Using EMS gear speeds ED rhythm analysis
Video review study of 223 OHCA patients found using EMS equipment for initial ED rhythm analysis reduced median time to first rhythm analysis by 143 seconds and first defibrillation by 131.5 seconds compared with ED equipment.
-
Persistent OHCA inequality across England
Retrospective analysis of 165,701 OHCA patients in England 2018–23 found 23.6% of postcode districts remain high-risk (higher OHCA incidence, lower bystander CPR rates), with urban deprived areas showing 71.2% BCPR versus 79.1% in low-risk areas, though ROSC and survival were slightly higher in high-risk areas.
-
Kidney biomarkers predict outcomes after OHCA
Prospective study of 82 comatose OHCA patients found kidney-specific biomarkers (plasma and urinary NGAL and KIM-1, cystatin C) were superior to serum creatinine for early AKI detection and prediction of poor neurological outcomes at discharge.
-
MRI profiles of postanoxic status epilepticus
Two-center study of 192 postanoxic patients using quantitative MRI found postanoxic status epilepticus exhibited more favorable hypoxic-ischemic brain injury profiles (higher whole-brain ADC values) compared with generalized periodic discharges or malignant EEG patterns.