“LACTATE CLEARANCE IS PREDICTOR OF MORTALITY IN CRITICALLY ILL CHILDREN”

2021 ◽  
pp. 71-73
Author(s):  
Khodaija Mahvish ◽  
Girijanand Jha ◽  
Binod Kr Singh
Keyword(s):  
Critically Ill ◽  
Lactate Level ◽  
Early Period ◽  
Lactate Clearance ◽  
Mortality Prediction ◽  
Critically Ill Children ◽  
Female Ratio ◽  
Prism Score ◽  
Male Female Ratio ◽  
High Level

Background and Objectives: High lactate level in blood (hyperlactatemia) is a frequent phenomenon in critically ill children which carries signicant prognostic value. However, a single lactate value is a static variable and can only serve as a risk-stratication biomarker and such a “high” level is not well dened. Studies have conrmed 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 signicant difference in the initial lactate level in those who survived vs those who died (p=0.19). However, there was a statistically signicantly lower lactate in survivors at 8 hours as compared to non survivors (p <0.0001). Lactate clearance at 8 hours was also signicantly 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 specicity of 94.7% in mortality prediction. Mean PRISM score was also signicantly 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

scholarly journals A deep learning model for real-time mortality prediction in critically ill children

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Soo Yeon Kim ◽  
Saehoon Kim ◽  
Joongbum Cho ◽  
Young Suh Kim ◽  
In Suk Sol ◽  
...  
Keyword(s):  
Deep Learning ◽  
Real Time ◽  
Critically Ill ◽  
Learning Model ◽  
Mortality Prediction ◽  
Critically Ill Children ◽  
Deep Learning Model

Can Lactate Clearance Predict Mortality in Critically Ill Children?

2021 ◽  
Author(s):  
Azza A. Moustafa ◽  
Abeer S. Elhadidi ◽  
Mona A. El-Nagar ◽  
Hadir M. Hassouna
Keyword(s):  
Critically Ill ◽  
Odds Ratio ◽  
Survival Curve ◽  
Tertiary Care ◽  
Prognostic Significance ◽  
Lactate Clearance ◽  
Critically Ill Children ◽  
Multivariate Logistic Regression Model ◽  
Arterial Blood ◽  
Group A

AbstractSerial evaluation of blood lactate, including lactate clearance, may have greater value over single measurement at the time of presentation. The rationale of the current study was to evaluate the use of lactate clearance after 6 hours of admission to pediatric intensive care unit (PICU) as a predictor of mortality in critically ill children. A prospective observational study was conducted in a nine-bed PICU of a tertiary care teaching hospital over a period of 6 months. Lactate levels were measured in arterial blood samples of 76 patients at the time of admission and 6 hours later. According to calculated lactate clearance, patients were divided into group A (lactate clearance more than 0) which included 71% of patients and group B (lactate clearance ≤0) which included 29% of patients. Lactate level at admission was a poor predictor of mortality (area under receiver operating characteristic curve [AUC] = 0.519, p = 0.789). Lactate clearance after 6 hours of admission was a significant predictor of mortality (AUC = 0.766, p < 0.001). Using Kaplan–Meier survival curve, overall survival was significantly better among group A (p < 0.001). Using multivariate logistic regression model, lactate clearance after 6 hours (odds ratio = 0.98, 95% confidence interval [CI]: 0.96–0.99) and The Pediatric Index of Mortality 2 (PIM2) score (odds ratio = 4.7, 95% CI: 1.85–12.28) had independent prognostic significance as regard to mortality (p = 0.030, 0.001 respectively). We conclude that lactate clearance after 6 hours of admission can predict mortality in critically ill children.

scholarly journals Hypomagnesemia as a predictor of mortality in critically ill pediatric patients in picu using prism score

2019 ◽  
Vol 6 (3) ◽  
pp. 1294
Author(s):  
Poornima Shankar ◽  
N. Varsha Monica Reddy ◽  
Shiva Devaraj
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Pediatric Patients ◽  
Clinical Status ◽  
Critically Ill Children ◽  
P Value ◽  
Prism Score ◽  
Low Magnesium ◽  
Prediction Of Mortality ◽  
High Prevalence

Background: Magnesium is the fourth most abundant cation in the human body and the second most abundant intracellular cation after potassium. A potential relationship between low magnesium levels and increased mortality has been suggested in the literature. The objectives were to detect prevalence of hypomagnesemia in critically ill children, its association with sepsis and to correlate this with mortality.Methods: This study was an observational study done on 100 children who met the inclusion criteria, admitted to the PICU of Kempegowda Institute of Medical Sciences, Bangalore, Karnataka, India. Patients under the study were managed and treated according to their clinical status and supportive traditional treatment.Results: Prevalence of hypomagnesemia in critically ill pediatric patients was 53%. In this study, majority of the cases admitted to PICU were dengue (19%) and bronchopneumonia (15%) which were significantly associated with hypomagnesemia as p value was less than 0.05. As regard prognosis, Mg had an AUC of 0.576 for prediction of mortality whereas the AUC for PRISM score was 0.811. Logistic regression analysis showed that hypomagnesemia is a significant predictor for mortality among critically ill children (p value=0.028) and OR=3.180 (0.854-7.965).Conclusions: Present study has found high prevalence of hypomagnesemia in critically ill patients. Hypomagnesemia was associated with a higher mortality rate in critically ill patients and commonly associated with infections and respiratory diseases. Hypomagnesemia indicated poor outcome and higher mortality rates in critically ill patients.

scholarly journals The Use of PELOD Score in Predicting Acute Kidney Injury in Critically Ill Children

2016 ◽  
Vol 36 (2) ◽  
pp. 165-169
Author(s):  
Risky Vitria Prasetyo ◽  
Putu Dian Saraswati ◽  
Muhammad Riza Kurniawan ◽  
Hari Kushartono ◽  
Ninik Asmaningsih Soemyarso ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Critically Ill ◽  
Demographic Data ◽  
Kidney Injury ◽  
Prognostic Indicators ◽  
Critically Ill Children ◽  
Female Ratio ◽  
Logistic Organ Dysfunction ◽  
End Stage ◽  
Pelod Score

Introduction: Acute kidney injury (AKI) significantly increases morbidity and mortality in critically ill children. Prognostic indicators such as Pediatric Logistic Organ Dysfunction (PELOD) score is associated with factors related to renal dysfunction. The aim of this study was to study the AKI incidence and correlate the PELOD score with AKI in critically ill children admitted to PICU at Dr. Soetomo Hospital Surabaya Indonesia.Material and Methods: A prospective study was conducted to all children admitted to PICU during 15 January-14 April 2014. Demographic data (age, sex, PICU indications, PELOD scores, AKI staging by pRIFLE at admission) and outcome after 7 days at PICU were recorded. All data were analyzed descriptively (p<0.05).Results: A total of 56 (47.1%) out of 119 children were studied. The rest was excluded for being <3 months old, had end-stage kidney disease or complex cardiac problem, and cardiac catheterization. Mean age of subjects was 49.7 (SD 46.2) months, male-to-female ratio of 1.2:1. PICU indication was dominated by shock (35.7%), followed by CNS dysfunction in 13 (23.2%) and respiratory failure in 12 (21.4%) children. AKI was noted in 15 (26.8%) children, mostly (10.7%) in Injury stage with 5 (8.9%) in Risk and 4 (7.1%) in Failure stages. PELOD scores at admission ranged from 0 to 20 (mean 4.34, SD 5.87), higher scores in AKI group (7.8±6.64 vs 3.1±5.09, P=0.013). Twelve (21.4%) children died, 7 (58.3%) had AKI with 3 (25.0%) each in Risk and Failure while 1(8.3%) in Injury (p<0.05).Conclusion: PELOD score can be used as a predictor for AKI in critically ill children.J Nepal Paediatr Soc 2016;36(2):165-169.

scholarly journals Variplex™ test system fails to reliably detect SARS-CoV-2 directly from respiratory samples without RNA extraction

2020 ◽  
Vol 39 (12) ◽  
pp. 2373-2377 ◽  
Author(s):  
Florian Eckel ◽  
Franziska Küsters ◽  
Bernhard Drossel ◽  
Markus Konert ◽  
Hans Mattes ◽  
...  
Keyword(s):  
False Negative ◽  
Rna Extraction ◽  
False Negative Rate ◽  
Test System ◽  
Isothermal Amplification ◽  
Lamp Method ◽  
Female Ratio ◽  
Negative Rate ◽  
Male Female Ratio ◽  
High Level

AbstractDiagnosis of COVID is performed by PCR methods, but their capacity is limited by the requirement of high-level facilities and instruments. The loop-mediated isothermal amplification (LAMP) method has been utilized for the detection of isolated virus-specific RNA. Preliminary data suggest the possibility of isothermal amplification directly from respiratory samples without RNA extraction. All patients admitted to our hospital were screened for SARS-CoV-2 by routine. Respiratory samples were tested by variplex system based on LAMP method directly without RNA extraction and by PCR. Primary endpoint was the false-negative rate of variplex test compared with PCR as gold standard. In 109 patients variplex test and PCR assay were performed simultaneously. Median age was 80 years and male/female ratio was 40/60%. The prevalence of PCR-confirmed COVID diagnosis was 43.1%. Variplex test was positive in 13.8%. False-negative rate of variplex test compared with PCR was 83.0%. The potential of LAMP technology using isolated RNA has been demonstrated impressively by others, and excellent sensitivity and specificity of detecting SARS-CoV-2 has been reported. However, without RNA extraction, the variplex test system failed to reliably detect SARS-CoV-2 directly in respiratory samples.

scholarly journals The Effect of Thiamine Supplementation for Critically Septic Patient: An Evidence-Based Case Report

2021 ◽  
Vol 5 (1) ◽  
pp. 15
Author(s):  
Ayu Diandra Sari ◽  
Melyarna Putri ◽  
Sheena R. Angelia ◽  
Mulianah Daya ◽  
Anak Agung Eka Widya Saraswati ◽  
...  
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Age Groups ◽  
Normal Liver ◽  
Lactate Clearance ◽  
Evidence Based ◽  
Lactate Acidosis ◽  
High Level ◽  
The University

Sepsis has been accounted for various burdens worldwide, especially in critically ill patients. This could eventually lead to inflammatory response, provocation ischemia and lactic acidosis. On the other hand, thiamine was suggested as a coenzyme which could improve the outcome of those patients. Thus, we conducted an evidence-based case study with research on PubMed, ProQuest, and Scopus using a search strategy focusing on RCT or cohort study on thiamine supplementation/level towards the outcome of critically ill patients with sepsis. We found three articles eligible for review after full-text assessment. Articles were appraised using the University of Oxford’s tools for critical appraisal. It was known that all studies were good in terms of validity and applicability. This study showed that thiamine supplementation could improve lactate clearance and reduce mortality risk, moreover, thiamine deficiency could increase the risk of lactate acidosis. However, a high level of thiamine was associated with a high level of lactate in patients with liver failure. Therefore, thiamine supplementation could be recommended for critically ill patients with sepsis and normal liver function. Further research, such as RCT or systematic review on thiamine supplementation for age groups to make this study more applicable.

scholarly journals Study of Premature Infant during Early Period of Life

2015 ◽  
Vol 7 (1) ◽  
pp. 115-118
Author(s):  
Mohammad Abdullah Al Mamun ◽  
Md Mahbubul Hoque ◽  
MAK Azad Chowdhury ◽  
M Monir Hossain ◽  
Mahfuza Shirin ◽  
...  
Keyword(s):  
Very Low Birth Weight ◽  
Early Period ◽  
Somatic Growth ◽  
Growth Chart ◽  
Anthropometric Parameters ◽  
Anthropometric Parameter ◽  
Female Ratio ◽  
Vlbw Infants ◽  
Medical College ◽  
Male Female Ratio

Background : There is suboptimal growth observed among the very low birth weight (VLBW) infants during postnatal period.Objectives : This study was conducted to evaluate the anthropometric parameters among preterm VLBW infants during early period of life.Methods : This was a retrospective study of preterm VLBW infants admitted to Dhaka Shishu (Children) Hospital during the period of July 2011 to June 2013. Body weight, length and occipitofrontal circumference (OFC) at birth and at 4 weeks was recorded from neonatal data base. Z-scores for each anthropometric parameter were computed using Fenton’s growth chart of preterm infants. Statistical analysis was done using SPSS version 21.0.Results : Total 88 preterm VLBW infants were included in the study and among them male were 61.4% and female were 38.6% with a male female ratio 1.59:1. Mean weight, length and OFC at birth was 1186±277.45gm, 38.23±2.89 cm and 27.46±2.20cm respectively and at 4 weeks 1460.81±295.73 gm, 41.23±2.87 cm and 29.91±2.19 cm respectively. At birth small for gestational age (SGA) was found in 44.3% but at 4 weeks majority (77.3%) failed to achieve appropriate weight. Z score of weight, length and OFC at birth was -1.19, -0.58 and - 0.24 respectively and at 4 weeks-2.01, -1.17 and -0.75 respectively. There was a significant decline in all three anthropometric parameters from birth to 4 weeks of life (p<0.05).Conclusion : There was decrease in all anthropometric parameters among preterm VLBW neonate at 4 weeks of life. Despite significant decrease in somatic growth they maintained a near normal head growth.Northern International Medical College Journal Vol.7(1) Jul 2015: 115-118

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