Point-of-care lactate in pediatric sepsis: a single-center observational study

Lactate is a key biomarker in the assessment of sepsis, reflecting tissue hypoperfusion and correlating with disease severity and outcomes. However, reliance on standard laboratory testing may delay clinical decision-making in time-sensitive situations. Point-of-care (POC) lactate testing provides rapid bedside assessment, potentially facilitating earlier risk stratification and intervention. This study aimed to evaluate the predictive value of POC lactate for pediatric intensive care unit (PICU) admission and mortality in pediatric patients with sepsis.

This was a retrospective observational study of children aged 3 months to 14 years presenting to the pediatric emergency department in a tertiary care children's hospital with a diagnosis of sepsis. Data were extracted from electronic medical records.

A total of 149 pediatric patients with sepsis were included, of whom 90 underwent POC lactate testing. Elevated POC lactate levels were observed in 38.9% of tested patients. Elevated POC lactate was significantly associated with PICU admission, as well as the need for mechanical ventilation and inotropic support. Receiver operating characteristic (ROC) analysis demonstrated modest but statistically significant predictive performance for PICU admission (AUC = 0.641), whereas no predictive value was observed for mortality (AUC = 0.544).

Point-of-care lactate may serve as a practical supplementary biomarker that can facilitate early risk stratification by identifying children with sepsis at increased risk of PICU admission and requiring advanced interventions. Nevertheless, its modest discriminatory performance necessitates interpretation in conjunction with clinical assessment and additional biomarkers rather than as an independent predictor of sepsis severity.