Early arterial lactate and prediction of outcome in preterm neonates admitted to a neonatal intensive care unit.
OBJECTIVE
In the present study early arterial lactate samples were examined to predict adverse outcome in preterm neonates.


METHODS
88 preterm neonates (mean gestational age 29.8 weeks, mean birth weight 1,225 g) had arterial lactate levels measured from indwelling arterial catheters within the first 3 h of life. An adverse outcome was defined as death or abnormal neurodevelopment. The positive (PPV) and negative predictive value (NPV) of early arterial lactate levels for an adverse outcome (death or neurodevelopmental abnormalities) were calculated using receiver operating characteristic analysis.


RESULTS
PPV and NPV of arterial lactate within 3 h after birth were 0.47 and 0.92, respectively, with a cutoff value of 5.7 mmol/l. Umbilical blood gas values and 1 and 5 min Apgar scores had much lower PPVs.


CONCLUSIONS
Arterial lactate levels within 3 h of life can be used to select preterm neonates who are at risk of an adverse outcome.
Groenendaal
Floris
F
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands. F.Groenendaal@wkz.azu.nl
Lindemans
Caroline
C
Uiterwaal
Cuno S P M
CS
de Vries
Linda S
LS
D001034:Apgar Score; D005312:Fetal Blood; D005740:Gases / Q000097:blood; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D007236:Infant, Small for Gestational Age / Q000097:blood; D007363:Intensive Care Units, Neonatal; D019344:Lactic Acid / Q000097:blood*; D011379:Prognosis; D013997:Time Factors
D005740:Gases; D019344:Lactic Acid