Hyperlactatemia in Critically Ill Children: The Clinical Value of Lactate for Predicting Mortality in the Pediatric Intensive Care Unit
Journal Title: Journal Of Pediatric Critical Care - Year 2018, Vol 5, Issue 1
Abstract
Objective: To determine the prevalence of hyperlactatemia among critically ill children and to evaluate the clinical value of lactate levels measured at admission to the pediatric intensive care unit (PICU) to predict mortality. Methods: This prospective observational study was conducted in a tertiary care PICU. 356 critically ill children admitted in PICU were taken for study. Serum lactate level measured at admission, with 306 patients classified in the norm lactatemia group (< 2 mmol/l) and 50 in the hyperlactatemia group (≥ 2 mmol/l). Main outcome measures recorded were Pediatric Risk of Mortality score (PRISM III), predicted mortality score, length of stay in the PICU, need for mechanical ventilation and vasopressor, and death. Results: The prevalence rate of hyperlactatemia was 13.8%, which was associated with an increased length of stay in the PICU, longer duration of mechanical ventilation, increased need for vasopressor, and higher mortality (p<0.05). The following cut-off criteria were predictive of mortality: baseline lactate, >5.42 mmol/l; lactate clearance at 6 h, ≤11.87%; persistent hyperlactatemia at 24 h >3.02 mmol/l; PRISM III score, >10; and predicted mortality score, >5.66. Lactate clearance at 6 h and persistent hyperlactatemia at 24 h had predicted mortality with the highest sensitivity 95% and specificity 100%. Conclusions: A single baseline lactate at admission can predict mortality at admission comparable to PRISM III score. Clearance of lactate at 6 h and hyperlactatemia at 24 h can predict death with the highest sensitivity and specificity.
Authors and Affiliations
Bijay Kumar Meher, Devadarshini Sahoo, Deepti Damayanty Pradhan, Saroj Kumar Satpathy, Alok Satyaprakash Nayak
Keywords
Related Articles
- EP ID EP336765
- DOI 10.21304/2018.0501.00361
- Views 55
- Downloads 0
Hemodynamic Monitoring in PICU
.
Successful endovascular occlusion of ruptured intracranial mycotic aneurysm in a child with Ventricular Septal Defect and infective endocarditis – A case report
Infective endocarditis is associated with significant morbidity and mortality. Neurologic complications associated with infective endocarditis are cerebral infarction, bacterial meningitis, intracerebral haemorrhage, and...
Inborn Error Of Amino Acid And Ketone Body Metobolism (A Beta Keto Thiolase Defeciency;A Rare Case Report DOI-10.21304/2018.0501.00227
Background : β-ketothiolase deficiency is an organic acid disorder that result from inability to process the amino acid isoleucine and ketone bodies. Its deficiency occurs in less than 1 in 100000 births. Till date aroun...
Knowledge of Pediatric Sepsis among Trainees
Introduction: Sepsis is one of the leading causes of death in children inthe developing world. Several studies have shown that the knowledge and implementation of current American College of Critical Care Medicine- Pedia...
SpO2 Target in Bronchiolitis
.