bağ, özlem behçet uz çocuk hastanesi - pediyatri kliniği, İzmir, Turkey , karaarslan, utku behçet uz çocuk hastanesi - çocuk yoğun bakım ünitesi, İzmir, Turkey , işgüder, rana behçet uz çocuk hastanesi - çocuk yoğun bakım ünitesi, İzmir, Turkey , apa, hurşit behçet uz çocuk hastanesi - pediyatri kliniği, İzmir, Turkey , devrim, ilker behçet uz çocuk hastanesi - çocuk enfeksiyon hastalıkları, İzmir, Turkey , ağın, hasan behçet uz çocuk hastanesi - çocuk yoğun bakım ünitesi, İzmir, Turkey

The reasons of hyperlactatemia on admission and relationship of the lactate levels with clinical outcomes in pediatric intensive care unit

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Purpose: Hyperlactatemia has been reported to predict mortality and morbidity in critically ill patients. The aim of this study is to define the reasons of hyperlactatemia on admission in critical pediatric patients, to describe a cut off value to predict mortality and to evaluate the outcomes of admission hyperlactatemia in pediatric intensive care unit. Materials and methods: Hospital records of 202 pediatric patients who had admitted to pediatric intensive care unit (Male/Female: 101/101; median age: 3 years [IQR: 9.2] ) were evaluated retrospectively, for the study. Age, gender, admission diagnosis, arterial blood gas analysis, length of stay, presence of in-hospital mortality were recorded in the study group. Hyperlactatemia was defined according to L-lactate levels defined by age. The patients with and without hyperlactatemia were compared for mortality and clinical outcomes. Results:The frequency of admission hyperlactatemia was 64.3% (n: 130). The patients with dehydration due to acute gastroenteritis, acute respiratory insufficiency and acaute cardiac insufficiency had significantly higher lactate levels compared with children with other diagnosis. Admission hyperlactatemia was not found to have a cut-off value to predict mortality by ROC analysis (Area under curve: 0.57). Moreover, hyperlactatemia was not found to effect either mortality rate or outcome in the study group. Conclusion: The results of this study indicate that admission hyperlactatemia may not be used as a predictor of either death or poor clinical outcome in pediatric intensive care units. Further there is a lack of cut off value for lactate in literature to predict outcomes in different pediatric ages.

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Hyperlactatemia , admission , childhood , PICU

Pamukkale Medical Journal

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