Hubungan Kadar Laktat Serum Inisial dan Skor Pelod pada Anak dengan Sepsis

Abstract

Latar belakang. Sepsis merupakan masalah kesehatan penting pada anak. Salah satu alat ukur terbaik untuk memperkirakan keparahan penyakit pada anak sepsis adalah skor pediatric logistic organ dysfunction (PELOD). Kadar laktat serum inisial adalah prediktor lain dalam menentukan keparahan penyakit pada anak sepsis yang mudah dilakukan dan hasilnya cepat diperoleh. Tujuan. Mempelajari hubungan antara kadar laktat serum inisial dan skor PELOD pada anak sepsis. Metode. Penelitian analitik dari bulan November sampai Desember 2013 di Instalasi Gawat Darurat Anak (IGDA) RS Prof Dr.R.D Kandou, Manado. Sampel darah diambil untuk pemeriksaan laktat dan dihitung skor PELOD untuk tiap pasien. Untuk analisis selanjutnya digunakan korelasi Pearson dan regresi linear, signifikan apabila p<0,05. Hasil. Terdapat 45 anak sepsis dengan rerata usia 5 tahun. Rerata kadar laktat serum inisial lebih rendah secara bermakna pada pasien yang bertahan hidup dibandingkan pasien yang meninggal (3,67±0,92 berbanding 6,77± 4,62 mmol/L, p=0,013). Rerata skor PELOD juga lebih rendah secara bermakna pada pasien yang bertahan hidup dibandingkan pasien yang meninggal (13,51±13,16 berbanding 25,75±15,82, p<0,01). Didapatkan korelasi rendah antara kadar laktat serum inisial dan skor PELOD (r=0,42, p=0,004). Background. Sepsis remains an important health problem in children. One of the best available tools to estimate the severity of illness in critically ill septic children is The Pediatric Logistic Organ Dysfunction (PELOD) score. Early lactate serum is a potentially feasible and clinical useful predictor of mortality in sepsis patients. Objective. To study the correlation between initial lactate serum and PELOD score in children with sepsis. Methods. We performed a prospective analytic study from November to December 2013 in Pediatric Intensive Care Unit (PICU) Prof. dr. R. D. Kandou Hospital, Manado. Blood sample was taken for lactate examination and PELOD score for each patient was calculated. Further analysis was done using Pearson correlation and linear regression. Test results were statistically significant if p < 0.05. Results. There were 45 children with sepsis, with mean age of 5 years old. Mean initial lactate serum were significantly lower in survivors compared with non-survivors (3.67±0.92 vs 6.77 ± 4.62 mmol/L, p=0.013) and mean PELOD score were also significantly lower in survivors compared with non-survivors (13.51 ± 13.16 vs 25.75±15.82, p <0.01). We found a significant positive correlation between initial lactate serum and PELOD score (r= 0.42, p=0.004). Conclusion. There was a positive correlation between initial lactate serum and PELOD score in children with sepsis. Sari Pediatri 2016;18(3):192-7

The Role of Lactate Level as Predictor of Mortality Critically Ill Children at Moewardi Hospital

“…This is slightly different from the study before. In study conducted by Meher et al, the average initial lactate level of patients who died was 6.19 mmol/L, whereas in study conducted in Indonesia by Gunawan et al, the average lactate level was 4.77 mmol/l (Gunawan et al, 2017). In these results have the same conclusion that lactate levels >2 mmol/l can increase patient mortality.…”