Lactate clearance as a marker of mortality in Pediatric Intensive Care Unit

Objectives

To correlate lactate clearance with Pediatric Intensive Care Unit (PICU) mortality.

Methods

45 (mean age 40.15 mo, 60% males) consecutive admissions in the PICU were enrolled between May 2012 to June 2013. Lactate clearance (Lactate level at admission — level 6 hr later × 100 / lactate level at admission) in first 6 hours of hospitalization was correlated to in-hospital mortality and PRISM score.

Results

Twelve out of 45 patients died. 90% died among those with delayed/poor clearance (clearance <30%) compared to 8.5% in those with good clearance (clearance >30%) (P<0.001). Lactate clearance <30% predicted mortality with sensitivity of 75%, specificity of 97%, positive predictive value of 90%, and negative predictive value of 91.42%. Predictability was comparable to PRISM score >30.

Conclusion

Lactate clearance at six hours correlates with mortality in the PICU.