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Identification and Quantification of Deranged Metabolites in Critically Ill Patients Using NMR-Based Metabolomics
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A Near Real-Time Risk Analytics Algorithm Predicts Elevated Lactate Levels in Pediatric Cardiac Critical Care

Ahmed Asfari1, Joshua Wolovits2, Avihu Z Gazit3

  • 1Department of Pediatric Cardiology, Section of Cardiac Critical Care Medicine, University of Alabama at Birmingham, Birmingham, AL.

Critical Care Explorations
|December 6, 2023
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Summary
This summary is machine-generated.

A novel hyperlactatemia (HLA) index accurately predicts elevated serum lactate levels in pediatric cardiac ICU patients. This noninvasive tool offers early warnings for clinicians, aiding in managing low-cardiac output syndrome.

Keywords:
analytic algorithmsinadequate delivery of oxygenlow-cardiac output statepediatric cardiac surgeryrisk estimationserum lactate

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Area of Science:

  • Pediatric Cardiology
  • Critical Care Medicine
  • Biomedical Engineering

Background:

  • Postoperative pediatric congenital heart patients are at risk for low-cardiac output syndrome.
  • Serum lactate (LA) is a key indicator of inadequate systemic oxygen delivery.

Purpose of the Study:

  • To test a noninvasive predictive analytics algorithm for a near real-time risk index.
  • To predict elevated serum lactate (LA) in pediatric cardiac intensive care unit (CICU) patients.

Main Methods:

  • A retrospective observational study validated a hyperlactatemia (HLA) index using T3 platform data.
  • The study included 3,496 pediatric patients (age ≤ 12) admitted to CICUs.
  • An algorithm using Bayes' theorem calculated the HLA index from physiologic data.

Main Results:

  • The HLA index demonstrated high sensitivity and specificity in predicting hyperlactatemia (area under the curve 0.95).
  • Increased HLA index values correlated with a higher likelihood of elevated LA levels (p < 0.01).
  • The index showed significant predictive power for both high and low LA levels.

Conclusions:

  • The HLA index is validated as a noninvasive predictor of elevated LA.
  • This novel index may provide early warnings of impaired cardiac output and oxygen delivery.
  • Prospective studies are needed to evaluate the index's impact on clinical decisions and patient outcomes.