Clinical Role of Serum Lactate Dehydrogenase Assessment in Critically Ill Pediatric Patients with Sepsis

Abstract

Sepsis is a systemic inflammatory disorder that may be associated with higher rate of morbidity and mortality in pediatric patients admitted to intensive care unit with sepsis. Usage of different biomarkers may be helpful for early detection and appropriate management of sepsis. Our objectives was to investigate the role of serum lactate dehydrogenase in prediction of sepsis in critical pediatric patients, and its relation with prognostic scoring systems. A prospective cohort study was conducted at El Galaa teaching hospital between January 2020 and December 2020. A total of 168 pediatric patients were divided into the septic group (84) critically ill patients with sepsis from the pediatric intensive care unit (PICU)] and control group (84 stable patients admitted to the inpatient word). Demographic and clinical data were collected, routine laboratory investigation including LDH on admission and after 24 hours were performed. Pediatric Risk of Mortality III (PRISMIII) and Sequential Organ Failure Assessment (pSOFA) were assessed. Serum LDH level was significantly higher in septic group than control (P=0.000) and in non-survivor than survivor group (P=0.000). Also there was statistically significant correlation between survivor and non-survivor as regarding length of hospitality, pSOFA score and PRISMIII score. There was statistically significant positive correlation between LDH, PRISMIII (r=0.842, P<0.001) and pSOFA (r=0.785, P<0.001). We concluded that LDH is a useful marker in predicting of sepsis in critically ill pediatric patients especially when combined with prognostic scoring systems.