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Published on: September 17, 2021
Importance of measuring lactate levels in children with sepsis
1Liverpool Hospital, Liverpool NSW, Australia.
Insights
Early recognition of sepsis and rapid resuscitation are crucial, especially in children. Measuring blood lactate levels aids in assessing sepsis severity and resuscitation effectiveness, guiding timely clinical intervention.
Area of Science:
- Critical Care Medicine
- Pediatric Emergency Medicine
- Biomarker Research
Background:
- Sepsis is a leading cause of preventable death, particularly in children, due to delayed recognition and resuscitation.
- Effective sepsis management relies on early identification of signs, symptoms, and prompt intervention.
- Blood lactate levels serve as a key indicator for assessing sepsis severity and resuscitation efficacy.
Purpose of the Study:
- To highlight the importance of lactate level measurement in sepsis diagnosis and management.
- To discuss the pathophysiology of lactate production and its causes in sepsis.
- To provide guidance on lactate measurement, interpretation, and nursing management in sepsis.
Main Methods:
- Review of current literature and clinical practices in Australia and the UK regarding sepsis management.
- Analysis of the role of blood lactate levels in conjunction with clinical symptoms and other biomarkers (oxygen, carbon dioxide).
- Discussion of the limitations and appropriate cautious interpretation of elevated lactate levels.
Main Results:
- Lactate levels are easily obtainable and should be measured within six hours of suspected sepsis presentation, with repeat testing at four and eight hours.
- Combined analysis of clinical symptoms, oxygen, carbon dioxide, and lactate levels is recommended for sepsis diagnosis.
- Elevated lactate levels require careful consideration of other potential aetiologies.
Conclusions:
- Lactate measurement is a vital tool in the sepsis diagnostic and management pathway.
- Clinicians must exercise caution when interpreting elevated lactate levels, considering all potential causes.
- Standardized protocols for lactate measurement and nursing management are essential for improving sepsis outcomes.
Abstract:
Sepsis is a major public health problem as well as one of the leading causes of preventable death in children because of failure to recognise the early signs and symptoms and to resuscitate rapidly. Blood lactate levels are used to assess the severity of sepsis and the effectiveness of resuscitation. Lactate levels are easily obtainable and should be checked in all patients admitted with suspected sepsis within six hours of presentation. The test should be repeated four and eight-hours post-diagnosis of sepsis. For the diagnosis of sepsis, patients' clinical symptoms, along with the combined analysis of partial pressure of oxygen, carbon dioxide and lactate levels, should be used. A multitude of factors can cause elevated lactate levels and so clinicians should use elevated levels cautiously by considering all other aetiologies. This article, which focuses on practice in Australia but makes reference to the UK, discusses the importance of measuring lactate levels in sepsis, the pathophysiology of lactate production, causes of elevated lactate levels, lactate measurement, nursing management of patients with elevated lactate levels, limitations of using lactate as a biomarker for diagnosing sepsis and implications for practice.
