Lactate to creatinine ratio: just another biomarker?

Area of Science:

• Pediatric critical care medicine
• Biomarker research
• Sepsis diagnostics

Background:

• Limited effective biomarkers exist for pediatric sepsis outcomes.
• Lactate is a common but variable sepsis severity marker.
• The lactate-to-creatinine ratio (LCR) integrates metabolic and organ dysfunction markers.

Purpose of the Study:

• To examine the rationale for LCR in pediatric sepsis.
• To critique the limitations of single time-point LCR assessments.
• To evaluate LCR's potential for actionable clinical decision-making.

Main Methods:

• Review of existing literature on LCR in pediatric critical care.
• Analysis of LCR's biological plausibility and data availability.
• Critique of current evidence regarding LCR's clinical utility.

Main Results:

• Pediatric LCR evidence is primarily from early intensive care unit measurements.
• Single time-point assessments may not capture sepsis's dynamic nature.
• LCR's ability to inform clinical decisions requires further investigation.

Conclusions:

• LCR shows promise as a composite biomarker for pediatric sepsis risk stratification.
• The clinical relevance of LCR is questioned due to limited dynamic assessment data.
• Future research should focus on LCR's impact on patient-centered outcomes and clinical decision-making.