• Niger J Clin Pract · Sep 2023

    Can lactate be valuable in early diagnosis and prognosis of neonatal sepsis?

    • F M Kislal, C C Polat, E Ergül, A A Açıkalın, D Güven, E Gündoğan, and D Sarıcı.
    • Department of Pediatrics, University of Health and Sciences, Ankara Atatürk Sanatorium Training and Research Hospital, Ankara, Turkey.
    • Niger J Clin Pract. 2023 Sep 1; 26 (9): 131913251319-1325.

    BackgroundSepsis monitoring tissue perfusion is crucial for detecting circulatory failure early, implementing the right treatments, and assessing response. Insufficient oxygenation leads to a rise in lactate level and has been shown to be useful in predicting mortality and morbidity in newborns. There have not been many studies on how lactate measurement affects neonatal sepsis diagnosis and prognosis.AimThe aim of our study was to determine the impact of lactate on early diagnosis and prognosis in neonatal sepsis.Materials And MethodsEighty-seven newborns diagnosed with neonatal sepsis at a neonatal intensive care unit between January 2010 and July 2021 were included in the study. Venous blood gas, lactate, and C-reactive protein (CRP) levels and complete blood count on the first, second, and third day of hospitalization were noted. Lactate values were correlated with other variables to determine the impact of hyperlactatemia on morbidity and to determine factors affecting the length of stay. IBM SPSS Statistics version 22.0 for Windows was used to analyze the data (SPSS Inc., Chicago, IL, United States).ResultsA strong negative correlation between lactate and oxygenation and perfusion indicators (HCO3, BE, PaO2) during the therapeutic process was observed. With treatment, the initial measured lactate value decreased, and a significant increase in CRP and oxygen saturation was observed, which was interpreted as the observation of an early lactate response to infection before a CRP response. The initial lactate level, as well as the change in lactate levels, was not, however, significantly correlated with the length of stay.ConclusionLactate can be used in the early diagnosis of neonatal sepsis and for determining prognosis.

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