Correlation of delta shock index and lactate clearance in shock patients treated in pediatric intensive care unit at Prof Dr. I.G.N.G Ngoerah Hospital

Abstract

Introduction: Lactate was an examination done in patients with shock as a predictor of mortality. The delta shock index (DSI) is one of the parameters that are easy to do but very limited studies related to the benefits of DSI have been found. This study aimed at determining the correlation of DSI and lactate clearance levels in pediatric shock patients treated at the Pediatric Intensive Care Unit (PICU) of Prof Dr. I.G.N.G Ngoerah Hospital. Method: This was a prospective cohort study of children diagnosed with shock in a pediatric emergency ward or PICU Prof Dr. I.G.N.G Ngoerah Hospital. A Spearman correlation test was done since the data distribution was abnormal. Multivariate analysis with multiple regression tests was carried out to assess the pure effect of lactate clearance with DSI. The level of significance was determined based on p <0.05. The general linear model analysis is done on variables that are repeated measurements. Result: There were 39 subjects obtained in this study, with 34 subjects surviving and 5 subjects not surviving. The median lactate clearance was 28.5 (-95 - 77.7), with a median DSI of 0.45 (0.04-1.3). There were significant differences in the decrease of shock index over time (p = 0.034). The correlation test results showed a weak positive between lactate clearance with DSI (r = +0.351) and p = 0.028. Multivariate analysis test results obtained a value of â 0.002 with p = 0.071. Conclusion: There was a weak positive correlation between lactate clearance and DSI. There were significant differences in the decrease of shock index over time between survivors and non-survivors.