Does lactate level in the first 12 hours of life predict mortality in extremely premature infants?

Corresponding Author

Farhat Hussain

Department of Neonatology, University of Queensland, Mater Mothers' Hospital and

Dr Farhat Hussain, Paediatric Critical Care Unit, Mater Children's Hospital, South Brisbane, Qld 4101, Australia. Fax: +61 7 31631642; email: [email protected]Search for more papers by this author

Kristen Gilshenan,

Kristen Gilshenan

Mater Research Support Centre, Mater Health Services, South Brisbane, Queensland, Australia

Search for more papers by this author

Peter H Gray,

Peter H Gray

Department of Neonatology, University of Queensland, Mater Mothers' Hospital and

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Farhat Hussain,

Corresponding Author

Farhat Hussain

Department of Neonatology, University of Queensland, Mater Mothers' Hospital and

Dr Farhat Hussain, Paediatric Critical Care Unit, Mater Children's Hospital, South Brisbane, Qld 4101, Australia. Fax: +61 7 31631642; email: [email protected]Search for more papers by this author

Kristen Gilshenan,

Kristen Gilshenan

Mater Research Support Centre, Mater Health Services, South Brisbane, Queensland, Australia

Search for more papers by this author

Peter H Gray,

Peter H Gray

Department of Neonatology, University of Queensland, Mater Mothers' Hospital and

Search for more papers by this author

First published: 28 April 2009

https://doi.org/10.1111/j.1440-1754.2009.01488.x

Citations: 18

Financial Support: No financial disclosures or conflicts of interest.

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Abstract

Aims: To determine if high lactate levels within the first 12 h of life independently or in combination with Clinical Risk Index for Babies (CRIB) II can predict mortality in extremely premature babies.

Study Design: A retrospective review of medical charts of babies born between 2001 and 2003 with birthweight <1000 g or gestation <28 weeks was performed. Blood gases and highest umbilical lactate levels in first 12 h of life were noted. Area under the curve (AUC) was calculated for lactate, CRIB and CRIB II as a predictor of mortality. The AUC for lactate and CRIB II were combined using discriminant analysis.

Results: Two hundred nineteen infants were included in the study, 41 (18.7%) of whom died. The AUC for lactate was 0.67 (P < 0.001), while AUCs for CRIB and CRIB II score were 0.81 (P < 0.001) and 0.82 (P < 0.001), respectively. The AUC for the combined measure of lactate and CRIB II was 0.82, similar to CRIB II.

Conclusions: Lactate predicts mortality in premature infants, but was found to be inferior to CRIB and CRIB II. Adding lactate level to CRIB II score does not improve its predictive ability.

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Volume45, Issue5

May 2009

Pages 263-267

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Neonatal-Perinatal Medicine

Does lactate level in the first 12 hours of life predict mortality in extremely premature infants?

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Does lactate level in the first 12 hours of life predict mortality in extremely premature infants?

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