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VOLUME 15 , ISSUE 2 ( April, 2011 ) > List of Articles

RESEARCH ARTICLE

Serum lactate levels as the predictor of outcome in pediatric septic shock

Kana Ram Jat, Vinod K. Gupta

Keywords : Lactate level, pediatric, PRISM III score, septic shock

Citation Information : Jat KR, Gupta VK. Serum lactate levels as the predictor of outcome in pediatric septic shock. Indian J Crit Care Med 2011; 15 (2):102-107.

DOI: 10.4103/0972-5229.83017

License: CC BY-ND 3.0

Published Online: 01-04-2011

Copyright Statement:  Copyright © 2011; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background and Aims: An association of high lactate levels with mortality has been found in adult patients with septic shock. However, there is controversial literature regarding the same in children. The aim of this study was to find the correlation of serum lactate levels in pediatric septic shock with survival. Settings and Design: This was a prospective observational study at PICU of a tertiary care center of North India. Materials and Methods: A total of 30 children admitted to PICU with diagnosis of septic shock were included in the study. PRISM III score and demographic characteristics of all children were recorded. Serum lactate levels were measured in arterial blood at 0-3, 12, and 24 h of PICU admission. The outcome (survival or death) was correlated with serum lactate levels. Results: Septic shock was the most common (79.3%) type of shock and had 50% mortality. Initial as well as subsequent lactate levels were significantly higher in nonsurvivors. A lactate value of more than 45 mg/dl (5 mmol/l) at 0-3, 12, and 24 h of PICU admission had an odds ratio for death of 6.7, 12.5, and 8.6 (95% CI: 1.044-42.431, 1.850-84.442, 1.241-61.683) with a positive predictive value (PPV) of 38%, 71%, 64% and a negative predictive value (NPV) of 80%, 83%, and 83%, respectively. Conclusions: Nonsurvivors had higher blood lactate levels at admission as well as at 12 and 24 h. A lactate value of more than 45 mg/dl (5 mmol/l) was a good predictor of death.


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