Does lactate level in the first 12 hours of life predict mortality in extremely premature infants?
OBJECTIVE
To determine if high lactate levels within the first 12 h of life independently or in combination with Clinical Risk Index for Babies (CRIB) II can predict mortality in extremely premature babies.


METHODS
A retrospective review of medical charts of babies born between 2001 and 2003 with birthweight <1000 g or gestation <28 weeks was performed. Blood gases and highest umbilical lactate levels in first 12 h of life were noted. Area under the curve (AUC) was calculated for lactate, CRIB and CRIB II as a predictor of mortality. The AUC for lactate and CRIB II were combined using discriminant analysis.


RESULTS
Two hundred nineteen infants were included in the study, 41 (18.7%) of whom died. The AUC for lactate was 0.67 (P < 0.001), while AUCs for CRIB and CRIB II score were 0.81 (P < 0.001) and 0.82 (P < 0.001), respectively. The AUC for the combined measure of lactate and CRIB II was 0.82, similar to CRIB II.


CONCLUSIONS
Lactate predicts mortality in premature infants, but was found to be inferior to CRIB and CRIB II. Adding lactate level to CRIB II score does not improve its predictive ability.
Hussain
Farhat
F
Department of Neonatology, University of Queensland, Mater Mothers' Hospital, Mater Health Services, South Brisbane, Queensland, Australia. farhathussain2@aol.com
Gilshenan
Kristen
K
Gray
Peter H
PH
D005312:Fetal Blood / Q000737:chemistry; D017052:Hospital Mortality; D006801:Humans; D007226:Infant Mortality; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood*; D019102:Infant, Very Low Birth Weight / Q000097:blood*; D015931:Intensive Care, Neonatal / Q000379:methods; D019344:Lactic Acid / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors
D019344:Lactic Acid