Lactate profiles of pediatric shock patients in Cipto Mangunkusumo General Hospital 2015: a pilot study

Yuniar, Irene

doi:10.14238/pi57.1.2017.12-7

Cited by 4 publications

(10 citation statements)

References 18 publications

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“…The majority of patients in this study suffered from septic shock. A similar study conducted in Jakarta also shows the domination of patients with septic shock (8). This is supported by the result of a randomized clinical trial which showed that septic shock is the most common type of shock, followed by hypovolemic shock, cardiogenic shock, and obstructive shock (9).…”

Section: Discussionmentioning

confidence: 68%

“…This study was dominated by patients with alactatemia (blood lactate level being under the pathological range). A study conducted in a general hospital in Jakarta shows a similar result, where in a group of pediatric shock patients most of the lactate blood levels were recorded as normal to low (8). The condition of hyperlactatemia (blood lactate level being above the normal range) has been known as a marker of tissue hypoxia.…”

Section: Discussionmentioning

confidence: 73%

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Hemodynamic Profile of Pediatric Patients Admitted to Pediatric Intensive Care Unit Dr. Soetomo General Hospital

Aldora¹,

Setyaningtyas²,

Andriyanto³

et al. 2022

IJRP

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Background: Shock is one of the most commonly found conditions and causes high mortality rates in PICU. Macrocirculation and microcirculation hemodynamic monitoring is performed to know the degree of severity of the shock, to determine the treatment to be given, and to evaluate the previous treatments given. Objective: This study aims to determine the hemodynamic disturbances profile of pediatric patients in PICU of Dr. Soetomo General Hospital Surabaya in the period of 1 st September 2021-31 st May 2022. Methods: This study was an observational cross-sectional study. The data obtained were processed and analyzed using Microsoft Excel. Results: A total of 32 samples met the inclusion and exclusion criteria. The majority of the patients in this study (84,38%) suffered from septic shock. The macro-circulation hemodynamic measurements, the majority of the patients had normal blood pressure (53,13%), inadequate stroke volume (75%), tachycardia (78,13%), normal cardiac output (59,38%), normal SVR (68,75%), and inadequate DO2 (53,13%). In the microcirculation hemodynamic measurement, the majority of the patients had alactatemia (65,63%). Conclusion: The measurements of several hemodynamic parameters in majority of the pediatric shock patients showed the abnormality related to the shock condition, whereas the other parameters were in their normal ranges as the result of the early resuscitations given before the PICU administrations.

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Section: Discussionmentioning

confidence: 68%

Section: Discussionmentioning

confidence: 73%

Hemodynamic Profile of Pediatric Patients Admitted to Pediatric Intensive Care Unit Dr. Soetomo General Hospital

Aldora¹,

Setyaningtyas²,

Andriyanto³

et al. 2022

IJRP

View full text Add to dashboard Cite

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“…Their study demonstrated that only 37% of pediatric shock patients had increased lactate. [ 18 ] A previous study by Scott et al . demonstrated normalization of lactate within 2–4 h of presentation, with decreased risk of persistent organ dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Validation of the vasoactive-inotropic score in predicting pediatric septic shock mortality

Pudjiadi¹,

Pramesti²,

Pardede³

et al. 2021

International Journal of Critical Illness and Injury Science

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Introduction: Mortality in pediatric septic shock remains very high. Vasoactive-inotropic score (VIS) is widely used to predict prognosis in patients with heart disease. It is a simple method that was initially used as a predictor of morbidity and mortality in postoperative patients with congenital heart diseases. Previous reports showed that high VIS score was associated with high mortality in pediatric sepsis. However, its discriminative value remains unclear. We aim to explore the discriminative value of VIS in predicting mortality in pediatric septic shock patients. Methods: We conducted a retrospective cohort study on medical records of septic shock patients who received care in the pediatric intensive care unit (PICU). We screened medical records of pediatric patients which were diagnosed with septic shock and admitted to the PICU and received vasoactive/inotropic score for more than 8 h. Other supporting examination results were recorded, such as organ function evaluation for calculation of Pediatric Logistic Organ Dysfunction-2 (PELOD-2) score. The outcome of patients was recorded. The receiver operating curve was constructed to calculate the area under the curve (AUC), sensitivity, and specificity of each cutoff point. Results: We obtained the optimum cutoff point of VIS > 11 with 78.87% sensitivity and 72.22% specificity. AUC positive was 0.779 ( P < 0.001); predictive value and negative predictive value were 91.80% and 46.43%, respectively. Conclusion: VIS > 11 has a good ability to predict mortality in children with septic shock.

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“…Furthermore, a single-center study in India by Gadappa and Behera reported that shock incidence in a pediatric intensive care unit (PICU) was 8.6% [ 3 ]. According to a retrospective study, septic shock was the most frequent type of shock (51%) among children admitted to the emergency department and the PICU, followed by hypovolemic (38.1%), cardiogenic (6.5%), and other distributive shocks (4.4%) [ 4 ]. This finding was in accordance with the results from De Backer et al [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

The role of cardiac power and lactate clearance as an indicator of resuscitation success among pediatric patients with shock in the intensive care unit of Cipto Mangunkusumo Hospital

et al. 2023

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Background Shock in children remains the primary cause of mortality and morbidity worldwide. Furthermore, its management outcome is improved using many hemodynamic parameters, such as cardiac power (CP) and lactate clearance (LC). Cardiac power is a contractility index based on the measurement of flow and pressure, and it is a relatively new hemodynamic parameter with limited studies. In contrast, LC has been proven useful as a target outcome in shock resuscitation. This study aims to explore the values of CP and LC in pediatric shock and their association with clinical outcomes. Methods This prospective observational study was conducted on children (1 month-18 years old) with shock at Cipto Mangunkusumo Hospital, Indonesia, from April to October 2021. We measured CP using ultrasonic cardiac output monitoring (USCOM®) and serum lactate levels at 0, 1, 6, and 24 h post-initial resuscitation. Subsequently, the variables were described and analyzed with the resuscitation success, length of stay, and mortality. Results A total of 44 children were analyzed. There were 27 (61.4%), 7 (15.9%), 4 (9.1%), 4 (9.1%), and 2 (4.5%) cases of septic, hypovolemic, cardiogenic, distributive, and obstructive shock, respectively. Within the first 24 h post-initial resuscitation, CP and LC had an increasing trend. Compared to children who had successful resuscitation, those who did not have successful resuscitation had similar CP at all time points (p > 0.05) and lower LC at 1 and 24 h post-initial resuscitation (p < 0.05). Lactate clearance was an acceptable predictor of resuscitation success (area under the curve: 0.795 [95% CI: 0.660–0.931]). An LC of 7.5% had a sensitivity, specificity, positive predictive value, and negative predictive value of 75.00%, 87.5%, 96.43%, and 43.75%, respectively. Lactate clearance in the first hour post-initial resuscitation had a weak correlation (r=-0.362, p < 0.05) with hospital length of stay. We found no difference in CP and LC among survivors compared to nonsurvivors. Conclusions We found no evidence that CP was associated with resuscitation success, length of stay, or mortality. Meanwhile, higher LC was associated with successful resuscitation and shorter length of stay at the hospital, but not mortality.

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Lactate profiles of pediatric shock patients in Cipto Mangunkusumo General Hospital 2015: a pilot study

Cited by 4 publications

References 18 publications

Hemodynamic Profile of Pediatric Patients Admitted to Pediatric Intensive Care Unit Dr. Soetomo General Hospital

Hemodynamic Profile of Pediatric Patients Admitted to Pediatric Intensive Care Unit Dr. Soetomo General Hospital

Validation of the vasoactive-inotropic score in predicting pediatric septic shock mortality

The role of cardiac power and lactate clearance as an indicator of resuscitation success among pediatric patients with shock in the intensive care unit of Cipto Mangunkusumo Hospital

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