Background and Objectives: High lactate level in blood (hyperlactatemia) is a frequent phenomenon in critically ill children which carries
signicant prognostic value. However, a single lactate value is a static variable and can only serve as a risk-stratication biomarker and such a
“high” level is not well dened. Studies have conrmed that serial measurements of lactate or lactate clearance (LC) over time serve as better
prognosticators of organ failure and mortality. In the present study, we studied the role of lactate clearance in early period of resuscitation (rst 8
hours of hospitalization) in mortality prediction. This prospective observational st Methodology: udy was conducted over 1 years from April 2019-
March 2020 including Children aged >1 month and <15 years admitted to PICU of our hospital. Lactate level estimation was done on admission
and after 8 hours of treatment for calculation of lactate clearance. Over the Results: study period, we enrolled 52 children in our study. Mean age
was 4.3 years (SD 1.9 years), male: female ratio was 1.26: 1 (29 males, 23 females). Mortality was 14 (26.9%) in the study population. There was no
statistically signicant difference in the initial lactate level in those who survived vs those who died (p=0.19). However, there was a statistically
signicantly lower lactate in survivors at 8 hours as compared to non survivors (p <0.0001). Lactate clearance at 8 hours was also signicantly
lower in those who died (5.85%) than those who survived (51.2%) (P=0.001). Lactate clearance <30% at 8 hours had a sensitivity of 71.4% and
specicity of 94.7% in mortality prediction. Mean PRISM score was also signicantly higher in non survivors as compared to those who survived
(P<0.0001). We also found an inverse relationship between lactate clearance and PRISM score Lactate clearance <30% at 8 hours and Conclusion:
PRISM III score more than 30 are predictive of mortality in critically ill children
Certainty and mortality prediction in critically ill children
