Role of Blood Lactate Clearance in Predicting Outcomes among Septic Patients Admitted to the PICU: A Prospective Cohort Study
Correspondence Address :
Mangla Sood,
Pratasha, North Oak Area, Sanjauli, Shimla-171006, Himachal Pradesh, India.
E-mail: drmanglasood@gmail.com
Introduction: A crucial metric for evaluating the effectiveness of microcirculation in septic shock is serum lactate. Lactate clearance within the first 24 hours of admission has predictive value for death in Paediatric Intensive Care Unit (PICU) admissions. Higher mortality was observed in septic patients who were unable to clear elevated admission lactate.
Aim: To determine the admission lactate level and to investigate whether failure to clear elevated lactate in septic patients can prognosticate high PICU mortality.
Materials and Methods: This prospective cohort study was conducted from August 2021 to July 2022 at PICU, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. A total of 75 children, aged two months to 18 years, admitted to the PICU for sepsis or septic shock, were enrolled in the study. The authors measured blood lactate at Intensive Care Unit (ICU) admission, at 6, 12, and 24 hours. Lactate clearance was calculated, and its association with mortality after 24 hours of PICU stay was measured using the Chi-square test.
Results: Out of the total, 55 survived, comprising 31 males (41.3%) and 44 females (58.7%). When comparing admission blood lactate to lactate clearance >10% at 6, 12, and 24 hours, there was no correlation between the two variables and mortality in PICU patients with sepsis.
Conclusion: Lactate clearance in the first 24 hours of PICU stay was recommended as a parameter associated with the mortality rate among septic patients. However, the authors did not find any correlation.
Child, Lactic Acid, Paediatric intensive care unit, Prognosis, Septic shock, Sepsis
DOI: 10.7860/JCDR/2024/66601.19164
Date of Submission: Jul 20, 2023
Date of Peer Review: Oct 10, 2023
Date of Acceptance: Jan 11, 2024
Date of Publishing: Mar 01, 2024
AUTHOR DECLARATION:
• Financial or Other Competing Interests: None
• Was Ethics Committee Approval obtained for this study? Yes
• Was informed consent obtained from the subjects involved in the study? Yes
• For any images presented appropriate consent has been obtained from the subjects. NA
PLAGIARISM CHECKING METHODS:
• Plagiarism X-checker: Jul 21, 2023
• Manual Googling: Oct 13, 2023
• iThenticate Software: Jan 09, 2024 (14%)
ETYMOLOGY: Author Origin
- Emerging Sources Citation Index (Web of Science, thomsonreuters)
- Index Copernicus ICV 2017: 134.54
- Academic Search Complete Database
- Directory of Open Access Journals (DOAJ)
- Embase
- EBSCOhost
- Google Scholar
- HINARI Access to Research in Health Programme
- Indian Science Abstracts (ISA)
- Journal seek Database
- Popline (reproductive health literature)
- www.omnimedicalsearch.com