LACTIC ACIDEMIA IN SICK NEONATES

Abstract

163 blood lactic acid (LA) determinations were performed on 42 infants admitted to the Newborn Special Care Unit. Mean values: In the RDS group, all patients with LA >50mg% developed intraventricular hemorrhage (IVH). IVH appeared to be more closely correlated to periods of increasing LA rather than decreased PaO2 or NaHCO3 therapy. No infant with LA>70mg% survived. All with >20mg% required assisted ventilation. Patients with rising LA had a poor prognosis. In cyanotic heart disease, a rise in LA was an early sign of decompensation and proved a valuable parameter for the timing of surgery. In general, increased LA was associated with increased serum osmolality, Na+ and glucose, but this relationship was not absolute. PaO2 could not be used as an index of LA. While increases in LA did not occur in some patients with PaO2≤40mm Hg, others with PaO2>50mm Hg developed severe lactic acidemia. Our data suggest that serial LA's provide both useful prognostic information and a more valid means of determining FiO2. LA determinations can be performed in 30 minutes. *CHD = Cyanotic Heart Disease, *RDS = Respiratory Distress Syndrome.