Acute cardiac care & resuscitation
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
Authors' conclusion
Among subjects enrolled in the THAPCA-OH trial, higher lactates within 6-h of ROSC were associated with unfavorable outcome at one year. Lactate has potential as an adjunct for early neuroprognostication and mortality prediction.
Study context
- Population
- Children after out-of-hospital cardiac arrest (OHCA) with at least one lactate measurement within 24-h of return of spontaneous circulation (ROSC)primary analysis, 82% had a primary unfavorable outcome
- Participants
- 213 children
- Comparison
- Lactate within 6 h of ROSC by 12-month outcome and hospital survival
- Primary endpoint
- Unfavorable neurobehavioral functioning or death
- Follow-up
- 12-months
Primary result
As reported in the abstract
Unfavorable neurobehavioral functioning or death
Primary unfavorable 12-month outcome
7.8
median first lactate within 6 h of ROSC
Favorable 12-month outcome
3.1
median first lactate within 6 h of ROSC
Difference (95% CI)
Primary unfavorable 12-month outcome vs favorable 12-month outcomemedian lactate higher in unfavorable outcome
4.8(3.7–5.9)
- Per 1 mmol/L lactate increase · odds of primary unfavorable outcome at 12-months increased
- odds 1.40 (95% CI 1.17–1.69)
Further findings
| Outcome | Primary unfavorable 12-month outcome | Favorable 12-month outcome | Died in the hospital | Survivors | Difference (95% CI) | |
|---|---|---|---|---|---|---|
| Hospital mortality · median lactate higher in those who died | Not reported in the abstract | Not reported in the abstract | median first lactate within 6 h of ROSC 8.6 | median first lactate within 6 h of ROSC 3.6 | 5.1 (4.0–6.1) | primary unfavorable 12-month outcome, favorable 12-month outcome: not reported in the abstract |
| −50510Difference (linear scale) |
AUROC across timepoints
- AUROCs showed strong association of lactate with all outcomes and were similar between timepoints
Original publication
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. Published 18 June 2026. doi:10.
Summarised from the published abstract; every number is checked against it