correlation between serum lactate at the time of admission and the final outcome of neonates admitted in the intensive care unit, an initial assessment

ABSTRACT

An assessment of neonates in order to pinpoint early recognition of circulatory failure, institution of appropriate treatment, and in assessing response in sick neonates in intensive care units and their outcome is one of the major concerns of the neonatologists. None of the routine assessments such as ABG, and scoring systems [SNAP II PE, CRIB] are highly sensitive in this regard. Tissue hypoperfusion, resulting from any threatening illnesses, leads the neonate to anaerobic metabolism and lactate generation. Blood lactate concentration has been used widely as reliable indicator of tissue hypoxia in this regard. We evaluated the possible relationship between arterial blood lactate level at time of admission and the outcome of 50 neonates who were admitted in neonatal intensive care unit [NICU] of Children's Medical Center in 2004. Other parameters such as clinical findings, SNAP II PE and CRIB scores, ABG indices, a possible need for mechanical ventilation and the duration of assisted ventilation were also considered along with the predictive value of blood lactate concentration. In alive neonates, lactate levels [21.3 +/- 10.6 mg/dl] were significant, comparing to those who died [42.0 +/- 26.5 mg/dl] [p=0.037]. The significant correlation between blood lactate concentrations and 02 saturation in ABG [p=0.02], and lactate levels and respiratory system involvement were relatively correlated [p=0.049] Blood lactate concentrations could be a useful tool in the prognosis of outcome in sick neonates in the intensive care units