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J Pediatr Intensive Care 2022; 11(02): 083-090
DOI: 10.1055/s-0042-1743180
Review Article

Serum Lactate and Mortality during Pediatric Admissions: Is 2 Really the Magic Number?

Rohit S. Loomba 
1   Division of Pediatric Cardiac Critical Care, Advocate Children's Hospital, Oak Lawn, Illinois, United States
2   Department of Pediatrics, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Chicago, Illinois, United States
,
Juan S. Farias 
3   Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
,
Enrique G. Villarreal 
3   Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Nuevo Leon, Mexico
,
Saul Flores 
4   Section of Critical Care Medicine and Cardiology, Texas Children's Hospital, Houston, Texas, United States
5   Department of Pediatrics, Baylor College of Medicine, Houston, Texas, United States
› Author Affiliations
Funding None.
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Abstract

The primary objective of this study was to determine if serum lactate level at the time of hospital admission can predict mortality in pediatric patients. A systematic review was conducted to identify studies that assessed the utility of serum lactate at the time of admission to predict mortality in pediatric patients. The areas under the curve from the receiver operator curve analyses were utilized to determine the pooled area under the curve. Additionally, standardized mean difference was compared between those who survived to discharge and those who did not. A total of 12 studies with 2,099 patients were included. Out of these, 357 (17%) experienced mortality. The pooled area under the curve for all patients was 0.74 (0.67–0.80, p < 0.01). The pooled analyses for all admissions were higher in those who experienced mortality (6.5 vs. 3.3 mmol/L) with a standardized mean difference of 2.60 (1.74–3.51, p < 0.01). The pooled area under the curve for cardiac surgery patients was 0.63 (0.53–0.72, p < 0.01). The levels for cardiac surgery patients were higher in those who experienced mortality (5.5 vs. 4.1 mmol/L) with a standardized mean difference of 1.80 (0.05–3.56, p = 0.04). Serum lactate at the time of admission can be valuable in identifying pediatric patients at greater risk for inpatient mortality. This remained the case when only cardiac surgery patients were included.

Keywords

lactic acid - pediatric - critical care - prognosis - mortality

Data Availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.




Publication History

Received: 09 September 2021

Accepted: 06 January 2021

Article published online:
18 February 2022

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