title: Serum lactate levels as the predictor of outcome in pediatric septic shock.
abstract: OBJECTIVE
  An association of high lactate levels with mortality has been found in adult patients with septic shock. However, there is controversial literature regarding the same in children. The aim of this study was to find the correlation of serum lactate levels in pediatric septic shock with survival.
  
  
  METHODS
  This was a prospective observational study at PICU of a tertiary care center of North India.
  
  
  METHODS
  A total of 30 children admitted to PICU with diagnosis of septic shock were included in the study. PRISM III score and demographic characteristics of all children were recorded. Serum lactate levels were measured in arterial blood at 0-3, 12, and 24 h of PICU admission. The outcome (survival or death) was correlated with serum lactate levels.
  
  
  RESULTS
  Septic shock was the most common (79.3%) type of shock and had 50% mortality. Initial as well as subsequent lactate levels were significantly higher in nonsurvivors. A lactate value of more than 45 mg/dl (5 mmol/l) at 0-3, 12, and 24 h of PICU admission had an odds ratio for death of 6.7, 12.5, and 8.6 (95% CI: 1.044-42.431, 1.850-84.442, 1.241-61.683) with a positive predictive value (PPV) of 38%, 71%, 64% and a negative predictive value (NPV) of 80%, 83%, and 83%, respectively.
  
  
  CONCLUSIONS
  Nonsurvivors had higher blood lactate levels at admission as well as at 12 and 24 h. A lactate value of more than 45 mg/dl (5 mmol/l) was a good predictor of death.
authors.affiliation: Department of Pediatrics, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India.
authors.forename: Kana Ram
authors.initials: KR
authors.lastname: Jat
authors.forename: Urmila
authors.initials: U
authors.lastname: Jhamb
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Gupta