A Munde1, N Kumar, R S Beri, J M Puliyel. 1. Department of Pediatrics, St. Stephens Hospital, Tis-Hazari, Delhi, India. Correspondence to: Dr Nirmal Kumar, 4, Rajpur Road, Qtr. B-2, Tis-Hazari, Delhi 110 054, India. nsk9_2000@yahoo.com.
Abstract
OBJECTIVE: To correlate lactate clearance with Pediatric Intensive Care Unit (PICU) mortality. METHODS: 45 (mean age 40.15 mo, 60% males) consecutive admissions in the PICU were enrolled between May 2012 to June 2013. Lactate clearance (Lactate level at admission - level 6 hr later x 100 / lactate level at admission) in first 6 hours of hospitalization was correlated to in-hospital mortality and PRISM score. RESULTS: Twelve out of 45 patients died. 90% died among those with delayed/poor clearance (clearance <30%) compared to 8.5% in those with good clearance (clearance >30%) (P<0.001). Lactate clearance <30% predicted mortality with sensitivity of 75%, specificity of 97%, positive predictive value of 90%, and negative predictive value of 91.42%. Predictability was comparable to PRISM score >30. CONCLUSION: Lactate clearance at six hours correlates with mortality in the PICU.
OBJECTIVE: To correlate lactate clearance with Pediatric Intensive Care Unit (PICU) mortality. METHODS: 45 (mean age 40.15 mo, 60% males) consecutive admissions in the PICU were enrolled between May 2012 to June 2013. Lactate clearance (Lactate level at admission - level 6 hr later x 100 / lactate level at admission) in first 6 hours of hospitalization was correlated to in-hospital mortality and PRISM score. RESULTS: Twelve out of 45 patients died. 90% died among those with delayed/poor clearance (clearance <30%) compared to 8.5% in those with good clearance (clearance >30%) (P<0.001). Lactate clearance <30% predicted mortality with sensitivity of 75%, specificity of 97%, positive predictive value of 90%, and negative predictive value of 91.42%. Predictability was comparable to PRISM score >30. CONCLUSION:Lactate clearance at six hours correlates with mortality in the PICU.
Authors: A Aramburo; Jim Todd; Elizabeth C George; Sarah Kiguli; Peter Olupot-Olupot; Robert O Opoka; Charles Engoru; Samuel O Akech; Richard Nyeko; George Mtove; Diana M Gibb; Abdel G Babiker; Kathryn Maitland Journal: BMC Med Date: 2018-03-09 Impact factor: 8.775