Minimal lactate clearance proclaims pediatric intensive care unit mortality

Abstract

Background: Lactate clearance among the survived patients is higher and is inversely related to the PRISM III Score. Objectives: We aimed to correlate lactate clearance with pediatric Intensive Care Unit (PICU) mortality. Material and Methods: This was prospective observational hospital-basedstudy conducted atPICU of GB Pant Tertiary Care Hospital, Government Medical College, Srinagar. All the enrolled 315 patients were in between >1 month to 14 years. Serum Lactate levels at PICU admission, 6 hours after PICU admission, Lactate Clearance and Pediatric Risk of Mortality Score (PRISM III) was estimated. Parameters were compared between and survived and expired group. Results: PICU mortality was 19.7%. Mortality rate was significantly high in the smaller age group children. Mean admission lactate level was significantly high (p<0.001) in the expired group 12.33±2.43mmol/L than the survived group 5.88±1.14mmol/L. Similarly; the mean lactate level after 6 hours in the expired group 10.60±2.58) mmol/L was significantly more (p<0.001) than the survived group 1.84±0.61. Lactate clearance at 6 hours was significantly low (p<0.001) in the expired group 4.97±9.60 than the survived group 68.58±14.97. Six-hour lactate clearance of ≤38.75% had predicted mortality, with a sensitivity of 98.39% and specificity of 99.60% Conclusions: Six-hour lactate clearance was a significant predictor of PICU mortality like PRISM III score.

Keywords

• lactate levels
• picu mortality
• and prism score