Abstract
Introduction. Lactate is an important indicator of tissue perfusion. The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. Methods. Longitudinal retrospective observational study. Forty-two patients were included between the age of 1 month and 17 years, with a diagnosis of sepsis and septic shock, who were admitted to the intensive care unit of a university referral hospital. The lactate value obtained from an arterial blood sample and a central venous blood sample drawn simultaneously, and within 24 hours of admission to the unit, was recorded. Results. The median age was 2.3 years (RIC 0,3–15), with a predominance of males (71.4%), having a 2.5 : 1 ratio to females. Most of the patients had septic shock (78.5%) of pulmonary origin (50.0%), followed by those of gastrointestinal origin (26.1%). Using Spearman's Rho, a 0.872 (p < 0.001) correlation was found between arterial and venous lactate, which did not vary when adjusted for age (p < 0.05) and the use of vasoactive drugs (p < 0.05). Conclusion. There is a good correlation between arterial and venous lactate in pediatric patients with sepsis and septic shock, which is not affected by demographic variables or type of vasoactive support.
Highlights
IntroductionThe objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock
Lactate is an important indicator of tissue perfusion
Our study found a good correlation between arterial and central venous lactate in pediatric patients with sepsis and/or septic shock who are in intensive care (Spearman’s index 0.897 and p < 0.001)
Summary
The objective of this study is to evaluate if there are significant differences between the arterial and central venous measurement of lactate in pediatric patients with sepsis and/or septic shock. There is a good correlation between arterial and venous lactate in pediatric patients with sepsis and septic shock, which is not affected by demographic variables or type of vasoactive support. Identification of organ dysfunction in patients was made based on clinical signs and symptoms (oliguria, altered consciousness) and identification of circulatory failure and consequent tissue hypoperfusion, with the presence of persistent and refractory hypotension (4-5). This approach is complicated due to the lack of sensitivity of the clinical findings to predict the presence or absence of an organ lesion or tissue hypoperfusion, especially in the pediatric population with physiological variables changing and complementary tests are typically needed [1]
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