[Value of blood lactic acid in evaluating disease severity and prognosis in children with sepsis].
OBJECTIVE
To investigate the value of blood lactic acid (BLA) in evaluating disease severity and prognosis in children with sepsis.


METHODS
A total of 484 children with sepsis were enrolled and divided into common sepsis group (n=310), severe sepsis group (n=105), and septic shock group (n=69). BLA level was measured before treatment, and the results of BLA re-examination after early fluid resuscitation were collected for children with septic shock and a BLA level of >2 mmol/L.


RESULTS
The BLA level increased with the increasing severity of sepsis. The analysis of the receiver operating characteristic curve showed that the cut-off value of BLA for the diagnosis of septic shock was 2.25 mmol/L, with a sensitivity of 82.6% and a specificity of 79.8%. The fatality rates in the BLA ≤1 mmol/L, BLA 1.1-2 mmol/L, BLA 2.1-4 mmol/L, and BLA >4 mmol/L groups were 8.5%, 9.4%, 27.2%, and 67.6%, respectively, and the risk of death in the BLA >4 mmol/L group was 22.4 times that in the BLA ≤1 mmol/L group. In children with septic shock who had a BLA level of >2 mmol/L before treatment and whose BLA levels were ≤2 mmol/L or >2 mmol/L after resuscitation, the fatality rates were 33.3% and 69.2%, respectively.


CONCLUSIONS
BLA can be used to evaluate disease severity and prognosis in children with sepsis, and a BLA level of 2.25 mmol/L has a high value in diagnosing septic shock. Early resuscitation helps BLA level return to normal and can improve the prognosis of children with septic shock.
Academy of Pediatrics, University of South China/Emergency Center, Hunan Children's Hospital, Changsha 410007, China. cszhuyimin@163.com.
Hai-Peng
HP
Yan
Xiu-Lan
XL
Lu
Jun
J
Qiu
Ping-Ping
PP
Liu
Chao
C
Zuo
Yi-Min
YM
Zhu
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D019344:Lactic Acid / Q000097:blood*; D008297:Male; D011379:Prognosis; D018805:Sepsis / Q000097:blood* / Q000401:mortality; D012720:Severity of Illness Index
D019344:Lactic Acid