{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T19:22:58Z","timestamp":1776712978986,"version":"3.51.2"},"reference-count":28,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T00:00:00Z","timestamp":1631750400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: While ECLS is a highly invasive procedure, the identification of patients with a potentially good prognosis is of high importance. The aim of this study was to analyse changes in the acid-base balance parameters and lactate kinetics during the early stages of ECLS rewarming to determine predictors of clinical outcome. Methods: This single-centre retrospective study was conducted at the Severe Hypothermia Treatment Centre at John Paul II Hospital in Krakow, Poland. Patients \u226518 years old who had a core temperature (Tc) &lt; 30 \u00b0C and were rewarmed with ECLS between December 2013 and August 2018 were included. Acid-base balance parameters were measured at ECLS implantation, at Tc 30 \u00b0C, and at 2 and 4 h after Tc 30 \u00b0C. The alteration in blood lactate kinetics was calculated as the percent change in serum lactate concentration relative to the baseline. Results: We included 50 patients, of which 36 (72%) were in cardiac arrest. The mean age was 56 \u00b1 15 years old, and the mean Tc was 24.5 \u00b1 12.6 \u00b0C. Twenty-one patients (42%) died. Lactate concentrations in the survivors group were significantly lower than in the non-survivors at all time points. In the survivors group, the mean lactate concentration decreased \u22122.42 \u00b1 4.49 mmol\/L from time of ECLS implantation until 4 h after reaching Tc 30 \u00b0C, while in the non-survivors\u2019 group (p = 0.024), it increased 1.44 \u00b1 6.41 mmol\/L. Conclusions: Our results indicate that high lactate concentration is associated with a poor prognosis for hypothermic patients undergoing ECLS rewarming. A decreased value of lactate kinetics at 4 h after reaching 30 \u00b0C is also associated with a poor prognosis.<\/jats:p>","DOI":"10.3390\/ijerph18189764","type":"journal-article","created":{"date-parts":[[2021,9,16]],"date-time":"2021-09-16T21:38:12Z","timestamp":1631828292000},"page":"9764","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Prognosis of Hypothermic Patients Undergoing ECLS Rewarming\u2014Do Alterations in Biochemical Parameters Matter?"],"prefix":"10.3390","volume":"18","author":[{"given":"Hubert","family":"Hymczak","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Intensive Care, John Paul II Hospital, 31-202 Krakow, Poland"},{"name":"Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1069-2659","authenticated-orcid":false,"given":"Pawe\u0142","family":"Podsiad\u0142o","sequence":"additional","affiliation":[{"name":"Institute of Medical Sciences, Jan Kochanowski University, 25-369 Kielce, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylweriusz","family":"Kosi\u0144ski","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Jagiellonian University Medical College, 31-008 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0042-5909","authenticated-orcid":false,"given":"Mathieu","family":"Pasquier","sequence":"additional","affiliation":[{"name":"Emergency Department, Lausanne University Hospital, University of Lausanne, 1015 Lausanne, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9019-0420","authenticated-orcid":false,"given":"Konrad","family":"Mendrala","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3715-0697","authenticated-orcid":false,"given":"Damian","family":"Hudziak","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rados\u0142aw","family":"Goco\u0142","sequence":"additional","affiliation":[{"name":"Department of Cardiac Surgery, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3687-512X","authenticated-orcid":false,"given":"Dariusz","family":"Plicner","sequence":"additional","affiliation":[{"name":"Unit of Experimental Cardiology and Cardiac Surgery, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, 30-705 Krakow, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Darocha","sequence":"additional","affiliation":[{"name":"Department of Anaesthesiology and Intensive Care, Medical University of Silesia, 40-055 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.resuscitation.2018.02.026","article-title":"Hypothermia outcome prediction after extracorporeal life support for hypothermic cardiac arrest patients: The HOPE score","volume":"126","author":"Pasquier","year":"2018","journal-title":"Resuscitation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1111\/aor.13818","article-title":"Outcomes of patients suffering unwitnessed hypothermic cardiac arrest rewarmed with extracorporeal life support: A systematic review","volume":"45","author":"Darocha","year":"2021","journal-title":"Artif. 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