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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
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Lactate clearance as a marker of mortality in pediatric intensive care unit

A Munde1, N Kumar, R S Beri

  • 1Department of Pediatrics, St. Stephens Hospital, Tis-Hazari, Delhi, India. Correspondence to: Dr Nirmal Kumar, 4, Rajpur Road, Qtr. B-2, Tis-Hazari, Delhi 110 054, India. nsk9_2000@yahoo.com.

Indian Pediatrics
|July 18, 2014
PubMed

Insights

Lactate clearance in the Pediatric Intensive Care Unit (PICU) is a strong predictor of mortality. Poor lactate clearance (<30%) within six hours indicates a significantly higher risk of death in critically ill children.

Area of Science:

  • Pediatric Critical Care Medicine
  • Biomarkers in Critical Illness
  • Clinical Outcomes Research

Background:

  • Lactate levels are a key indicator of tissue hypoperfusion in critically ill patients.
  • Assessing lactate clearance may offer insights into treatment effectiveness and patient prognosis.

Purpose of the Study:

  • To investigate the correlation between early lactate clearance and mortality in a Pediatric Intensive Care Unit (PICU) population.
  • To evaluate lactate clearance as a potential prognostic marker in pediatric critical illness.

Main Methods:

  • A cohort of 45 pediatric patients admitted to the PICU was studied.
  • Lactate clearance was calculated based on admission and 6-hour lactate levels.
  • Correlation with in-hospital mortality and Pediatric Risk of Mortality Score (PRISM) was assessed.

Main Results:

  • Twelve out of 45 patients (26.7%) died during hospitalization.
  • Patients with poor lactate clearance (<30%) had a 90% mortality rate, versus 8.5% for those with good clearance (>30%) (P<0.001).
  • Lactate clearance <30% demonstrated high sensitivity (75%) and specificity (97%) for predicting mortality, comparable to PRISM score >30.

Conclusions:

  • Early lactate clearance (within 6 hours) is significantly correlated with mortality in the PICU.
  • Lactate clearance serves as a valuable and reliable prognostic indicator in critically ill children.
  • This finding supports the use of lactate kinetics in routine PICU monitoring.
Abstract

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