Early lactate clearance in predicting in-hospital mortality in patients with sepsis admitted in the paediatric intensive care unit

Abstract

Introduction: Mortality due to sepsis is increasing in the PICUs of India. This study was conducted with the aim to investigate the prognostic value of lactate level at the time of admission and lactate clearance for mortality in sepsis and estimate its cut-off value of predicting mortality. This study also aimed to estimate the correlation between lactate clearance with PRISM III score (Pediatric Risk of Mortality score) and duration of stay. Materials and Methods: This was a prospective study on 150 patients admitted with severe inflammatory response syndrome with a probable infection in the paediatric intensive care unit with an estimation of serial lactate levels in the blood at 0–3 h, 24 h and 48 h of admission. Lactate clearance was calculated, and patients were followed up till discharge/death. Results: Out of 150 patients, there were 94 survivors and 56 non-survivors; the mean lactate clearance at 24 h was 6.16% in non-survivors, which was lower than survivors at 28.41%. The cut-off value of lactate clearance for predicting mortality was estimated to be 17.6%. PRISM III score and lactate clearance were inversely related. The duration of intensive care unit stay was more in non-survivors with low lactate clearance. Conclusion: Lactate clearance can be used as a prognostic measure for mortality in patients with sepsis and can be used as a guide for treatment.

Keywords

• lactate clearance
• mortality
• paediatric intensive care unit
• sepsis