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首页> 外文期刊>Pediatric emergency care >Evaluation of the Association of Early Elevated Lactate With Outcomes in Children With Severe Sepsis or Septic Shock
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Evaluation of the Association of Early Elevated Lactate With Outcomes in Children With Severe Sepsis or Septic Shock

机译：评估早期乳酸乳酸乳酸乳酸乳酸的关联，患有严重脓毒症或脓毒症休克儿童的结果

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Objective The aim of the study was to assess the association of initial lactate (L0) with mortality in children with severe sepsis. Methods This prospective cohort study included 74 patients younger than 18 years with severe sepsis admitted to the pediatric intensive care unit (PICU) of a tertiary, academic children's hospital with lactate measured within 3 hours of meeting severe sepsis or septic shock. The primary outcome was in-hospital mortality. The secondary outcomes included PICU and hospital length of stay. Results Although overall mortality was 10.5% (n = 18), patients with L0 measured (n = 72) had a higher mortality (16% vs 6%, P = 0.03) and higher median PRISM-III risk of mortality scores (P = 0.02) than those who did not. Median L0 was no different between nonsurvivors and survivors (3.6 mmol/L [interquartile range, 2.0-9.0] in nonsurvivors vs 2.3 mmol/L [interquartile range, 1.4-3.5] in survivors, P = 0.11). However, L0 was independently associated with PRISM-III score (coefficient, 1.12; 95% confidence interval, 0.4-1.8; P = 0.003) with an increase in mean PRISM-III score of 1.12 U for every 1 mmol/L increase in L0, with L0 accounting for 12% of the variability in PRISM-III scores between patients. There was no association between L0 and PICU or hospital length of stay. Conclusions Although our single center study did not demonstrate that an elevated early lactate is associated with mortality in pediatric severe sepsis, L0 did correlate strongly with PRISM-III, the most robust measure of mortality risk in pediatrics. Therefore, early lactate measurement may be important as an early biomarker of disease severity. These data should be validated in a larger, multicenter, prospective study.
机译：目的对该研究的目的是评估初始乳酸（L0）与严重败血症儿童死亡率的关联。方法该前瞻性队列研究包括74例比18岁的患者，严重脓毒症患者患有第三级学术儿童医院的儿科重症监护单位（PICU），乳酸乳酸乳酸乳酸乳酸乳酸率为6小时，以在患有严重的败血症或脓毒症休克的3小时内测量。主要结果是医院死亡率。二次结果包括PICU和医院的住宿时间。结果虽然总体死亡率为10.5％（n = 18），但L0测量的患者（n = 72）具有较高的死亡率（16％vs 6％，p = 0.03），较高的棱镜-III死亡率评分风险（P = 0.02）比那些没有的人。 Nonsurvivors和幸存者之间的中位L0在非幸存者中（3.6mmol / L [四分位数范围，2.0-9.0] Vs 2.3 mmol / L [四分位数范围，1.4-3.5]之间，P = 0.11）。然而，L0与棱镜III分数（系数，1.12; 95％置信区间，0.4-1.8; p = 0.003）独立相关，L0占患者之间的棱镜-III分数的12％的差异。 L0和PICU或医院逗留时间之间没有关联。结论虽然我们的单一中心研究没有表明早期乳酸升高与儿科严重败血症的死亡率相关，但L0确实与棱镜-III强烈关联，是儿科中死亡率最强的衡量标准。因此，早期乳酸测量可能是疾病严重程度的早期生物标志物。这些数据应在更大，多中心的前瞻性研究中验证。

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