Related Experiment Video
Updated: Aug 16, 2026
Left Lung Orthotopic Transplantation in a Juvenile Porcine Model for ESLP
Published on: February 14, 2022
[Blood lactate concentration as prognostic marker in critically ill children]
Adriana Koliski1, Izrail Cat, Dinarte J Giraldi
1Universidade Federal do Paraná (UFPR), Curitiba, PR, Brazil. akoliski@yahoo.com.br
Insights
Lactate levels in critically ill patients can indicate poor tissue perfusion. Early reduction in lactate levels at 24 hours significantly improves survival chances.
Area of Science:
- Critical Care Medicine
- Biochemistry
- Pediatrics
Background:
- Tissue hypoperfusion is a critical concern in critically ill patients.
- Lactate is a potential biomarker for assessing tissue perfusion status.
Purpose of the Study:
- To evaluate lactate as a marker of tissue hypoperfusion.
- To assess lactate's prognostic value in critically ill patients.
Main Methods:
- Prospective observational study of 75 pediatric ICU patients.
- Patients grouped by admission lactate levels (> or = 18 mg/dl vs. < 18 mg/dl).
- Serial lactate measurements and clinical evaluations performed.
Main Results:
- Higher admission lactate levels correlated with more hypoperfusion signs.
- Admission lactate levels differed significantly between early and late deaths.
- Lactate level at 24 hours showed high specificity (97.2%) for predicting death.
Conclusions:
- Elevated lactate levels (> or = 18 mg/dl) often indicate hypoperfusion.
- Lactate level normalization by 24 hours is linked to improved survival.
Objective:
To assess the use of lactate as a marker of tissue hypoperfusion and as a prognostic index in critically ill patients.
Methods:
Prospective, longitudinal, observational study of 75 patients admitted to the pediatric ICU of Hospital de Clínicas of Universidade Federal do Paraná, between November 1998 and May 1999. According to the lactate level on admission, patients were divided into group A (lactate > or = 18 mg/dl) and group B (lactate < 18 mg/dl). In terms of outcome, patients were classified into survivors and nonsurvivors. In group A, the clinical evaluation and the collection of arterial blood samples were performed on admission, at 6, 12, 24, 48 hours, and every 24 hours after that. In group B, they were carried out in the same way, but interrupted 48 hours after admission.
Results:
Groups A and B consisted of 50 and 25 patients, respectively. Group A presented more clinical signs of hypoperfusion (24/50). There was a statistically significant difference regarding the mean lactate levels on admission between those patients who died within 24 hours of admission (95 mg/dl) and those who died 24 hours after admission (28 mg/dl). The lactate level at 24 hours of admission revealed better sensitivity (55.6%) and specificity (97.2%) as a predictor of death.
Conclusions:
Most patients with lactate levels > or = 18 mg/dl showed clinical signs of hypoperfusion on admission. The normalization or reduction of lactate levels at and after 24 hours of admission was significantly related with higher chances of survival.