Treatment of Acute Circulatory Failure Based on Carbon Dioxide-Oxygen (CO2-O2) Derived Indices: The Lactel Randomized Multicenter Study
Authors' conclusion
Our results indicate that algorithm-based resuscitation using CO2-O2-derived indices did not improve lactate clearance or clinical outcomes compared with standard care.
Study context
- Population
- ICU patients aged ≥ 18 years with acute circulatory failure and arterial blood lactate ≥ 3 mM
- Participants
- 179 patients
- Comparison
- CO2-O2-derived algorithm-based treatment vs standard clinical practice
- Interventionaln = 89
- Controln = 90reference
- Primary endpoint
- Lactate clearance > 10%
- Follow-up
- 2 hours
Methodological detailsprospective, multicentre, single-anonymized, 3 ICUs
- Prospective
- Multicentre
- Single-anonymized
- 3 ICUs
Primary result
As reported in the abstract
P = 0.497
Secondary outcomes
Median
| Outcome | Interventional | Control | P value |
|---|---|---|---|
| Median change in lactate levels · 2 hours | −2.70% (IQR −22.58–19.1) | −10.53% (IQR −29.27–5.68) | P = 0.096 |
SOFA score
- No difference between groups: 6 [3 to 9] vs 7 [4 to 10]
- P = 0.719
ICU LOS
- No difference between groups: 4.5 days [2.0 to 10.8] vs 5.0 days [2.0 to10.0]
- P = 0.963
Hospital LOS
- No difference between groups: 11 days [3.0 to 27.0] vs 10 days [3.0 to 21.0]
- P = 0.493
28-day mortality
- No difference between groups: 44.9% vs 33.3%
- P = 0.150
Original publication
Treatment of Acute Circulatory Failure Based on Carbon Dioxide-Oxygen (CO2-O2) Derived Indices: The Lactel Randomized Multicenter Study. Chest. Published 28 November 2024. doi:10.
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