Lactate clearance at 6 hours after admission as a predictor of mortality in children with clinically suspected sepsis

Background: Causes of death in children with severe sepsis include septic shock, end organ damage and multiple organ dysfunction syndrome (MODS).

Objective: To ascertain whether lactate clearance predicts outcome of children with sepsis

Method: Prospective observational study was carried out among 100 children aged between 1 month and 12 years with clinical features of clinically suspected sepsis (Proven or suspected infection fulfilling at least two of the four criteria of Systemic Inflammatory Response Syndrome (SIRS)). Relevant investigations were carried out.

Results: The mean age of the children was 2.55 years. The incidence of death among the lactate non-clearance group was significantly more (84.2%) compared to only 17.8% among survivors. About 91.6% of the area was under curve which was statistically significant with a cut off value of lactate clearance was less than or equal to 12.7%.  The sensitivity at this level was 84.2%, specificity was 91.3%, positive likelihood ratio was 8.7, and negative likelihood ratio was 0.17. Lactate at zero hours and six hours was significantly more among non-survivors compared to survivors.

Conclusions: The serum lactate clearance level at 6 hours of admission demonstrated that it is a sensitive and specific marker in prediction of the mortality.

Sri Lanka Journal of Child health, 2022; 51(1): 34-38