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Research Article Open access CC BY 4.0

Study of Blood Lactate Levels at Admission as a Predictor of Mortality and Morbidity in Critically Ill Children in a Tertiary Care Pediatric Intensive Care Unit

Aleti Samatha, Suresh Kumar Panuganti, Venkateshwar Vempati, Sudha Boda

Asian Journal of Pediatric Research · pp. 75–83 · Published 23 Dec 2024

10.9734/ajpr/2024/v14i12412

Abstract

Background and Aim: Patients with severe illness are at an elevated risk of experiencing multiple organ failure, which in turn increases their likelihood of mortality. Hyperlactatemia is recognized as a distinct risk factor for the onset of organ dysfunction and mortality, as well as morbidity in children’s. Present study aims to to determine threshold values for the prediction of in-hospital mortality in the larger cohort of critically ill children and to evaluate the predictive value of blood lactate levels at admission. Methods: This prospective observational study was conducted with 202 critically ill children, ranging in age from one month to 18 years, admitted to the Pediatric Intensive Care Unit (PICU). Arterial blood samples were obtained upon admission, and subsequent measurements of lactate levels were conducted. The demographical data, clinical status and organ involvement were recorded. Statistical analysis was performed by using SPSS Version 21.0 and P < 0.05 was considered to be significant. Results: Survivors geometric mean lactate levels at admission were lower (1.2 mmol/L) than non-survivors' (4.8 mmol/L), and higher lactate levels at admission were substantially linked to both mortality and morbidity (length of hospital stay, need for ventilator and inotropic support). The sensitivity and specificity of the blood lactate levels were 93.6% and 89.7%, achieved at the optimal cut-off value of 4.05 mmol/L. The incidence of multi organ dysfunction, need for ventilator and inotropic support, duration of hospital stay in critically ill children was significantly associated with increased blood lactate levels at admission (P<0.01). Conclusion: A high level of blood lactate upon admission was independently predictive of in-hospital mortality in the pediatric population. The early identification of children who are at a high risk for mortality allows for prompt intervention, thereby enhancing the overall outcomes.

Blood lactate critically ill children cut-off value hospital stay hospital outcome

References (17)

  1. 1 Early Lactate-Guided Therapy in Intensive Care Unit Patients: A Multicenter, Open-Label, Randomized Controlled Trial [DOI]
  2. 2 Blood Lactate Levels Are Superior to Oxygen-Derived Variables in Predicting Outcome in Human Septic Shock [DOI]
  3. 3 The value of blood lactate kinetics in critically ill patients: a systematic review [DOI]
  4. 4 Lactate, a useful marker for disease mortality and severity but an unreliable marker of tissue hypoxia/hypoperfusion in critically ill patients [DOI]
  5. 5 Effectiveness of predicting in-hospital mortality in critically ill children by assessing blood lactate levels at admission [DOI]
  6. 6 Serum Lactate Level Has Prognostic Significance After Pediatric Cardiac Surgery [DOI]
  7. 7 Early hyperlactataemia in critically ill children [DOI]
  8. 8 Serum lactate levels as the predictor of outcome in pediatric septic shock [DOI]
  9. 9 Admission hyperlactatemia: Causes, incidence, and impact on outcome of patients admitted in a general medical intensive care unit [DOI]
  10. 10 Epidemiology of Sepsis in Children Admitted to PICUs in South America* [DOI]
  11. 11 Lactate clearance as the predictor of outcome in pediatric septic shock [DOI]
  12. 12 Validation of lactate clearance at 6 h for mortality prediction in critically ill children [DOI]
  13. 13 Lactate clearance as a marker of mortality in Pediatric Intensive Care Unit [DOI]
  14. 14 Point-of-care testing on admission to the intensive care unit: lactate and glucose independently predict mortality [DOI]
  15. 15 Persistent Hyperlactatemia as the Predictor of Poor Outcome in Critically Ill Children: A Single-Center, Prospective, Observational Cohort Study [DOI]
  16. 16 Sepsis epidemiology and outcome in the paediatric intensive care unit of Vilnius University Children’s Hospital [DOI]
  17. 17 The reasons of hyperlactatemia on admission and relationship of the lactate levels with clinical outcomes in pediatric intensive care unit [DOI]

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