|
|||||||
|
Prognostic Value of Serial Serum Lactate and Lactate Clearance in Paediatric Shock: A Prospective Observational Study |
|||||||
|
Fatema Huda, Vinod Ingale, Mohammad Haseeb, Imtiyaz Ahmad 1. Senior Resident, Department of Paediatrics, Mahatma Gandhi Mission’s (MGM) Medical College and Hospital, A Constituent Unit of MGM Institute of Health Sciences, Ch Sambhajinagar, Maharashtra, India. 2. Associate Professor, Department of Paediatrics, Mahatma Gandhi Mission’s (MGM) Medical College and Hospital, a Constituent Unit of MGM Institute of Health Sciences, Ch Sambhajinagar, Aurangabad, Maharashtra, India. 3. Professor, Department of Paediatrics, Mahatma Gandhi Mission’s (MGM) Medical College and Hospital, a Constituent Unit of MGM Institute of Health Sciences, Ch Sambhajinagar, Aurangabad, Maharashtra, India. 4. Resident, Department of Paediatrics, Mahatma Gandhi Mission’s (MGM) Medical College and Hospital, a Constituent Unit of MGM Institute of Health Sciences, Ch Sambhajinagar, Aurangabad, Maharashtra, India. |
|||||||
|
Correspondence Address : Mohammad Haseeb, P No. 98, N 13, CIDCO, Himayat Baugh, Aurangabad-431001, Maharashtra, India. E-mail: mohdhaseeb181@gmail.com |
|||||||
|
|||||||
| ABSTRACT |  | ||||||
: Introduction: Paediatric shock remains a major cause of morbidity and mortality in intensive care units. Early identification of children at high-risk of adverse outcomes is crucial. Serum lactate and lactate clearance have emerged as potential biomarkers of tissue hypoxia and adequacy of resuscitation, but data in paediatric shock across diverse aetiologies remain limited. Aim: To evaluate the prognostic significance of serial serum lactate levels and lactate clearance at 6, 12, and 24 hours in predicting mortality among children with shock. Materials and Methods: This prospective observational study was conducted over six months (April 2024 to September 2024) in the Paediatric Intensive Care Unit (PICU) of MGM Medical College and Hospital, Aurangabad, Maharashtra, India. Total 100 children aged 1 month to 18 years admitted with clinical shock and an initial serum lactate level ≥2 mmol/L were enrolled. Serum lactate levels were measured at admission and at 6, 12, and 24 hours. Lactate clearance was calculated for each interval. The primary outcome was survival status at hospital discharge. Comparisons between survivors and non-survivors were performed using the independent t-test/Mann-Whitney U test and Chi-square/Fisher’s-exact test as appropriate. ROC analysis was used to assess prognostic performance. Results: A total of 100 children were included; out of them, 72 survived and 28 died (mortality 28%). Non-survivors had significantly higher serum lactate levels at admission and at all subsequent time points (p<0.01). Lactate clearance was significantly lower in non-survivors than survivors at 6, 12, and 24 hours (13.4%, 22.4%, and 26.9% vs. 20.7%, 37.9%, and 55.2%, respectively; p<0.001). Persistently elevated lactate levels and poor lactate clearance were associated with increased mortality. Conclusion: Serial serum lactate measurements and lactate clearance during the first 24 hours of PICU admission are valuable prognostic markers in paediatric shock. Low lactate clearance identifies children at higher risk of mortality and may aid in early risk stratification and monitoring of resuscitation. | |||||||
|
|
|||||||
| Keywords : Critical illness, Haemodynamic instability, Paediatric intensive care, Prognostic biomarkers, Tissue hypoperfusion | |||||||
|
|
|||||||
|
DOI and Others :
DOI: 10.7860/IJNMR/2026/88544.2481
Date of Submission: Mar 09, 2026 Date of Peer Review: May 02, 2026 Date of Acceptance: Jul 10, 2026 Date of Publishing: Sep 30, 2026 AUTHOR DECLARATION: • Financial or Other Competing Interests: None • Was Ethics Committee Approval obtained for this study? Yes • Was informed consent obtained from the subjects involved in the study? Yes • For any images presented appropriate consent has been obtained from the subjects. NA PLAGIARISM CHECKING METHODS: • Plagiarism X-checker: Mar 11, 2026 • Manual Googling: Jul 03, 2026 • iThenticate Software: Jul 09, 2026 (8%) ETYMOLOGY: Author Origin EMENDATIONS: 7 |
|||||||
|
|
|||||||
|
|||||||
|
|
|||||||
Original article / research
|
Full Version