THE ROLE OF HYPERLACTATEMIA STATUS AS A PROGNOSTIC PARAMETER IN CRITICALLY ILL NENONATES

Article History

Submited : August 3, 2017
Published : March 17, 2016

ABSTRACT   Introduction:  Hypoxia and hypoperfussion is often found in neonates in an intensive care unit, however the clinical manifestations can only be found after cellular hypoxia and tissue perfussion disorder occur. Objective:  The study aims to find the ability of hyperlactatemia  status as a prognostic parameter  for infants in Neonatal Intensive Care Unit Level IIIA. Methods : The research was a cohort prospective study using bivariat and multivariat analysis in NICU of Dr. Wahidin Sudirohusodo Hospital from June 2012 to April 2013. The analysis of the lactate level on samples that met the inclusion and exclusion criterias was done immediately after the neonates get into the NICU level IIIA. The capliary lactate level was measured using hand held analyser. The samples were distributed into groups of hyperlactatemia and without hyperlactatemia followed by outcome observation (death or good recovery). The number of subjects were 102 patients consisted of  69 males and 33  females.  Results : The study showed the incidence of hyperlactatemia at NICU leve IIIA was 53,9%. Hyperlactatemia ((p=0.000; IK95% 4.11-56.75.00; AOR 15.28) and chronological age <24 hours (p=0.014; IK95% 1.5037.04; AOR 7.47) was significant in determining the patient’s outcome. Conclusions: The study found that hyperlactatemia status and cronological age less than 24 hours were prognostic factors for patient’s outcome related to elevated mortality risk.   Keywords: Hyperlactatemia, NICU, Critically ill infants

References

  1. Shah, S., Tracy, M., Smyth, J. Postnatal lactate as an early predictor of short-term outcome after intrapartum asphyxia. Journal of Perinatology. Nature Publishing Group. 2004; 24:16–20
  2. Rusmawati, A., L. Haksari, E. L., Naning, R. Downes score as a clinical assessment for hypoxemia in neonates with respiratory distress. Paediatrica Indonesiana. 2008; 48(6): 342 – 5.
  3. Yamanishi. S., Katsusia kronologia K., Kobayashi T., Puro D.G. Extracellular lactate as a dynamic vasoactive signal in the rat retinal microvasculature. Am J Physiol Heart Circ Physiol. 2004; 290: H925-H934.
  4. Agrawal, S., Sachdev, A., Gupta, D., Chugh, K. Role of lactate in critically ill children. Indian Journal Critical Care Medicine. 2004; 8 (3): 173-183.
  5. Valenza, F., Aletti, G., Fossali, T., Chevallard, G., Sacconi, F., Irace, M., Gattinoni, L. Critical care: Lactate as a marker of energi failure in critically ill patients: Hypothesis. PubMed. 2005; 9: 588-593.
  6. Cheung, Po-Yin, Etches, Philip, C., Weardon, Mary,. et al. Critical Care Medicine: Use of plasma lactate to predict early mortality and adverse outcome after neonatal extracorporeal membrane oxygenation: A prospective cohort in early childhood. Lippincott Williams & Wilkins. 2002;30(9): 2135-9.
  7. Rossi, A.F., Lopez, L., Dobrolet, D., Kha, D., Bolivar, J. Hyperlactatemia in neonates admitted to the cardiac intensive care unit with critical heart disease. Neonatology. S. Karger AG, Basel. 2010; 98: 212–6.
  8. Deshpande, S.A., Ward. M. P. P. Association between blood lactate and acid-base status and mortality in ventilated babies. Archives of Disease in Childood. 1997; 76: F15–F20.
  9. Noguera. A., Fortuny.C., Almagro. C.M., Sanches. E., Vilaseca. A., Artuch. R., Pou. J., et al. Hyperlactatemia in human immunodeficiency virus uninfected infants who are exposed to antiretrovirals. Pediatrics. American academy of pediatrics. 2004; 114: e598-e603.
  10. Fauchère, J.C., Bauschatz, A. S.,Arlettaz, R., Zimmermann-Bär, U., Bucher, H. U. Agreement between capillary and arterial lactate in the newborn. Acta Pediatric. Wiley. 2002; 91(1):78-81.
  11. Collange. O., Cortot, F., Meyer, A., Calon, B., Pottecher, T., Diemunsch, P. Critical care: Lactate measurement by the capillary method in shocked patients. BioMed Central Ltd. 2008; 12(2):169.
  12. Levy B. Lactate and shock state: the metabolic review. Current opinion in critical care. Lippincott Williams & Wilkins, Inc. 2006; 12 (14): 315-521.
  13. Platt M.W., Deshpande S. Metabolic adaption at birth. Elsevierhealth journals. 2005; 10: 341-350
  14. Nadeem M., Clarce A., Demsdey E.M. Day one serum lactate values in preterm infant less than 32 weeks gestation. Eur Jr pediatr. Spingerlink. 2010; 169(6):667-70.
  15. Hussain F., Gilshenan K., Gray P.H. Does lactate in the first 12 hours of life predict mortality in extremely premature infants?. J pediatr Child Health. 2009; 45(5): 263-7.
  16. Hall J.G. Variations in mortalities at Neonates ICUs. Nejm journal watch. 2002; 166:173-8.
  17. Mathews T.J., MacDorman M.F. Infant mortality statistics from the 2005 period link birth/infant death data set. Natl Vital Stat rep. 2008; 57(2):1.
  18. Gladden L.B. Lactate metabolisme: a new paradigm for the third millennium. The Journal of physiology. 2004; 558(1): 5-30.
  19. Robinson K., Kongable GL. Lactate in Critical Illness-Implications for Monitoring. US Respiratory Disease. 2010; 6:52-55.
Bahagia, A. D., Alasiry, E., A.M, D., & Kurniawati, H. (2016). THE ROLE OF HYPERLACTATEMIA STATUS AS A PROGNOSTIC PARAMETER IN CRITICALLY ILL NENONATES. Nusantara Medical Science Journal, (1), 33-40. https://doi.org/10.20956/nmsj.v0i1.2206

Downloads

Download data is not yet available.
Fulltext