Kadar Laktat Darah sebagai Faktor Risiko Mortalitas pada Sepsis Neonatorum

Abstract

Early, bedside, and readily available parameters to observe metabolic changes and predicted mortality in neonatal sepsis is still needed in every health facility. The aim of this study was to explore blood lactate as apossible mortality risk factor in neonatal sepsis. A prospective cohort study was held during the period of September–November 2010 involving newborns diagnosed as suffering from neonatal sepsis in Dr. Hasan Sadikin General Hospital Bandung. Blood lactate was measured with accutrend® lactate Plus at admission and in 2, 24 and 48 hours of hospitalization. We performed univariate analysis on subject characteristics, clinical symptoms, and laboratory examination data. Results with p<0.25 were re-analyzed using logistic regression. Significant results along with the 12 hour blood lactate level were analyzed using cox proportional hazard model. Based on the observation, of the 69 newborns included in this study, 28 died. Statistic analysis showed significant correlation between mortality and birth weight <2,500 gram (p=0.008), gestational age <37 weeks (p=0.006), retraction (p=0.010), and capillary refill time ≥3 seconds (p=0.042). Hyperlactatemia in 12 hours increased the risk for mortality in neonatal sepsis (HR 3.062, CI 95%:1.078–8.700). It is concluded that hyperlactatemia in 12 hours is the risk factor for mortality in neonatal sepsis.

Keywords

• Blood lactate
• mortality
• neonatal
• risk factor
• sepsis