Serial blood lactate levels as a prognostic factor for sepsis mortality
Journal Title: Paediatrica Indonesiana - Year 2014, Vol 54, Issue 3
Abstract
Background Sepsis is a major health problem in children and aleading cause of death. In recent decades, lactate has been studiedas a biomarker for sepsis, and as an indicator of global tissuehypoxia, increased glycolysis, endotoxin effect, and anaerobicmetabolism. Many studies h ave shown both high levels andincreased serial blood lactate level measurements to be associatedwith increased risk of sepsis mortality.Objective To evaluate serial blood lactate levels as a prognosticfactor for sepsis mortality.Methods We performed an observational, prospective study in thePediatric Intensive Care Unit (PICU) at DR. Sardjito Hospital,Yogyakarta from July to November 2012. We collected serialblood lactate specimens of children with sepsis, first at the time ofadmission, followed by 6 and 24 hours later. The outcome measurewas mortality at the end ofintensive care. Relative risks and 95%confidence intervals of the factors associated with mortality werecalculated using univariate and multivariate analyses.Results Sepsis was found in 91 (50.3%) patients admitted tothe PIW , of whom 75 were included in this study. Five patients(6. 7%) died before the 24-hour lactate collection and 39 patients(52.0%) died during the study. Blood lactate levels of ~ 4mmol;Lat the first and 24-hour specimens were associated with mortality(RR 2.9; 95%CI 1.09 to 7 .66 and RR 4.92; 95%CI 1.77 to 13.65,respectively). Lactate clearance of less than 10% at 24 hours(adjusted RR 5.3; 95% CI 1.1 to 24.5) had a significantly greaterrisk fo llowed by septic shock (adjusted RR 1.54; 95%CI 1.36 to6.4 7) due to mortality.Conclusion In children with sepsis there is a greater risk of mortalityin those with increasing or persistently high serial blood lactatelevels, as shown by less than 10% lactate clearance at 24-hours afterPIW admission.
Authors and Affiliations
Keswari Patriawati, Nurnaningsih Nurnaningsih, Purnomo Suryantoro
Keywords
Related Articles
- EP ID EP458723
- DOI 10.14238/pi54.3.2014.168-73
- Views 86
- Downloads 0
Multiple organ dysfunction syndrome associated with hyperglycemia in children requiring intensive care
Background Hyperglycemia can be caused by three or more organ dysfunctions and occurs in children requiring intensive care in the first 48 hours. Blood sugar level higher than 140 mg/dl is considered as hyperglycemia in...
Quality of sleep and hypertension in adolescents
Background Adolescents with hypertension are at risk of morbidity and mortality due to cardiovascular problems in later life. Hypertension may be influenced by poor quality of sleep, so early detection of hypertension an...
Management of Lowe syndrome: a case report
Lowe syndrome (the oculocerebrorenal syndrome of Lowe, OCRL) is a multisystem disorder characterized by anomalies affecting the eyes, nervous system and kidneys.1-3 The disorder was first recognized by Lowe et al. in 195...
The accuracy of a clinical parameters-based scoring system to predict spontaneous intracranial hemorrhage in children under one year old
Background Previous studies show that most children aged less than 1 year had intracranial hemorrhage without any history of trauma. The sign and symptoms of spontaneous intracranial hemorrhage (SIH) in children varies....
Relationship between children’s and parents’ blood pressure
Background A family history of hypertension is a risk factor forhypertension in children. Past studies have reported a significantrelationship between elevated blood pressure in children andhypertensive parents.Objective...