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Levels of lactic acid's concordance with pH in pediatric parapneumonic pleural effusion

Ana Estalella-Mendoza1, Alfonso María Lechuga-Sancho2, Jose Carlos Flores-González3

  • 1Pediatric Intensive Care Unit, Puerta del Mar University Hospital, Cádiz, Spain; Biomedical Research and Innovation Institute of Cadiz (INIBiCA), Cadiz, Spain.

Clinical Biochemistry
|July 4, 2021
PubMed

Insights

Pleural fluid lactate levels strongly correlate with pH in pediatric parapneumonic pleural effusion (PPE). High lactate may indicate the need for pleural drainage in children with PPE.

Area of Science:

  • Pediatric Pulmonology
  • Thoracic Medicine
  • Biomarker Discovery

Background:

  • The indication for pleural drainage in pediatric parapneumonic pleural effusion (PPE) remains debated.
  • Pleural fluid (PF) pH is a common but sometimes controversial indicator for drainage.
  • Novel biomarkers are needed to guide treatment decisions in pediatric PPE.

Purpose of the Study:

  • To investigate the correlation between PF lactate levels and pH in pediatric PPE.
  • To evaluate PF lactate as a potential biomarker for identifying the need for pleural drainage.
  • To compare lactate's utility against other PF parameters like glucose and LDH.

Main Methods:

  • A prospective study of 72 pediatric patients with PPE was conducted.
  • Patients were grouped based on PF pH (<7 for drainable, >7 for non-drainable).
  • PF lactate, glucose, and LDH levels were analyzed for correlation with pH and diagnostic accuracy.

Main Results:

  • A significant inverse correlation was found between PF lactate and pH (r=-0.7, p<0.001).
  • Higher lactate levels were observed in the drainable PPE group (p<0.001).
  • A lactate cut-off of 60.5 mmol/L showed high specificity (97.9%) for predicting pH <7.

Conclusions:

  • PF lactate demonstrates a strong correlation with pH in pediatric PPE.
  • Lactate shows potential as a highly specific biomarker for guiding pleural drainage decisions.
  • Further research may establish PF lactate as a valuable tool in managing pediatric PPE.

Keywords:
LactateParapneumonic pleural effusionPleural fluidpH

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