Predictive value of serum lactate dehydrogenase in diagnosis of septic shock in critical pediatric patients

Abstract

Objectives: To determine the predictive value of lactate dehydrogenase (LDH) in diagnosis of septic shock and its association with other prognostic scores in critical pediatric patients. Methods: A cross-sectional study was performed at Children's Hospital of Cairo University between June 2019 and December 2019. A total of 200 pediatric patients were divided into the septic shock group [100 critically ill patients with septic shock from the pediatric intensive care unit (PICU)] and the control group (100 patients with only sepsis). LDH was determined in the first 24 hours of admission. The sensitivity and specificity of LDH in diagnosis of septic shock were assessed; the levels of related indicators of patients with different etiologies were compared; correlations between LDH, Paediatric Index of Mortality Π, and Pediatric Sequential Organ Failure Assessment (PSOFA) were analyzed. Results: LDH was 512 μL (406.50-663.00) in the septic shock group and was significantly higher than that (190 μL, range 160.00-264.50) in the control group (P<0.001). Besides, median LDH in children with chest infecion was higher than that in children with other diagnoses (P=0.047). A good positive correlation was found between PSOFA and LDH (r=0.503, P<0.001). Conclusions: LDH could be a potential inflammatory marker in diagnosis of septic shock and is valuable for PICU admission decisions.