PS-186 Blood Lactate As A Predictive Marker For Neonatal Necrotising Enterocolitis (nec) Severity And Operative Outcomes: Abstract PS-186 Table 1

Abstract

Background and aims Lactate as a marker for tissue perfusion and hypoxia is increasingly used in routine point-of-care monitoring in critical care. We investigated the association of pre-operative lactate (PreL) with operative outcomes and mortality in neonatal surgical NEC. Methods 25 infants with NEC confirmed on laparotomy at a tertiary surgical centre were retrospectively evaluated. Maximal PreL was categorised as normal ( 5 mmol/L), and correlated to extent of NEC involvement and mortality. Results Median birth gestation and weight were 27weeks (range 23–33) and 1035g (555–2060). Median PreL was 5.1(range 0.6–16.2)mmol/L. Elevated PreL correlated with NEC severity, with predominance of pan-intestinal and multifocal involvement in severe hyperlactaemia (Table 1). Infants with isolated NEC were observed to have normal or moderate-PreL. Moderate to severe PreL was also associated with increased mortality rate and need for further surgery. Conclusions This preliminary study suggests that pre-operative hyperlactaemia and degree of elevation may be associated with a poor prognosis in infants with surgical NEC. Further larger studies may enable better evaluation of its use an adjunctive monitoring or prognostic tool in guiding early neonatal NEC management.