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Persistent Hyperlactatemia as the Predictor of Poor Outcome in Critically Ill Children: A Single-Center, Prospective,

Vinayak K Patki1, Jennifer V Antin2, Shweta H Khare2

  • 1Department of Pediatrics, Institute of Medical Education and Research, Vidyagiri, Satara, Maharashtra, India.

Journal of Pediatric Intensive Care
|May 11, 2019
PubMed

Insights

Persistent hyperlactatemia in critically ill children is linked to poor outcomes. This study found elevated lactate levels in non-survivors, highlighting its predictive value for mortality.

Area of Science:

  • Pediatric critical care medicine
  • Biochemistry
  • Clinical outcomes research

Background:

  • Hyperlactatemia is common in critically ill children.
  • Lactate levels may correlate with patient outcomes.
  • Predictive markers for mortality in pediatric intensive care are needed.

Purpose of the Study:

  • To determine the incidence of hyperlactatemia in critically ill children.
  • To investigate the correlation between hyperlactatemia and patient outcomes.
  • To assess lactate levels as a predictor of mortality.

Main Methods:

  • Prospective cohort study in a pediatric intensive care unit (PICU).
  • Serial serum lactate measurements in 140 critically ill children at 0, 12, 24, and 48 hours.
  • Correlation analysis between lactate levels and survival outcomes.

Main Results:

  • 45% of critically ill children exhibited hyperlactatemia.
  • Non-survivors had significantly higher lactate levels at all measured intervals (p=0.000).
  • Lactate levels decreased in survivors and increased in non-survivors (p=0.000); normalized lactate load predicted mortality (p=0.023).

Conclusions:

  • Persistent hyperlactatemia is a potential indicator of poor outcomes in critically ill children.
  • Lactate level trends can differentiate between survivors and non-survivors.
  • Monitoring lactate may aid in risk stratification and outcome prediction.

Keywords:
PICUPRISMcritically ill childrenhyperlactatemianormalized lactate load

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