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Lactate as predictor of mortality in child

Safwat A Aly, David Zurakowski, Penny Glass, Kami Skurow-Todd, Richard A Jonas, Mary T Donofrio
IMPORTANCE: There are no well-established noninvasive biomarkers for identifying patients at risk for poor outcome after surgery for congenital heart disease. Few studies have assessed prognostic accuracy of cerebral tissue oxygenation index (cTOI) measured by near infrared spectroscopy (NIRS). OBJECTIVE: To assess the utility of noninvasive NIRS monitoring as a predictor of outcomes after neonatal cardiac surgery through measurement of cTOI. To examine the utility of noninvasive NIRS monitoring in combination with lactate concentration and inotropic score in prediction of outcomes after neonatal cardiac surgery...
March 2017: Congenital Heart Disease
Heitor Pons Leite, Alessandra Vaso Rodrigues da Silva, Simone Brasil de Oliveira Iglesias, Paulo Cesar Koch Nogueira
OBJECTIVES: Serum albumin is a strong biomarker of disease severity and prognosis in adult patients. In contrast, its value as predictor of outcome in critically ill children has not been established. We aimed to determine whether admission hypoalbuminemia is associated with outcome in a general pediatric population of critically ill patients, taking into account the inflammatory response, disease severity, and nutritional status of the patient. DESIGN: Analysis of prospectively collected database...
February 2016: Pediatric Critical Care Medicine
Joseph Campbell, Joanne McPeake, Martin Shaw, Alex Puxty, Ewan Forrest, Charlotte Soulsby, Philp Emerson, Sam J Thomson, Tony M Rahman, Tara Quasim, John Kinsella
INTRODUCTION: The number of patients admitted to ICU who have liver cirrhosis is rising. Current prognostic scoring tools to predict ICU mortality have performed poorly in this group. In previous research from a single centre, a novel scoring tool which modifies the Child-Turcotte Pugh score by adding Lactate concentration, the CTP + L score, is strongly associated with mortality. This study aims to validate the use of the CTP + L scoring tool for predicting ICU mortality in patients admitted to a general ICU with cirrhosis, and to determine significant predictive factors for mortality with this group of patients...
October 13, 2015: Critical Care: the Official Journal of the Critical Care Forum
Rajesh Punn, David M Axelrod, Sara Sherman-Levine, Stephen J Roth, Theresa A Tacy
OBJECTIVES: Currently, there are no established echocardiographic or hemodynamic predictors of mortality after weaning venoarterial extracorporeal membrane oxygenation in children. We wished to determine which measurements predict mortality. DESIGN: Over 3 years, we prospectively assessed six echo and six hemodynamic variables at 3-5 circuit rates while weaning extracorporeal membrane oxygenation flow. Hemodynamic measurements were heart rate, inotropic score, arteriovenous oxygen difference, pulse pressure, oxygenation index, and lactate...
November 2014: Pediatric Critical Care Medicine
Philip Emerson, Joanne McPeake, Anna O'Neill, Harper Gilmour, Ewan Forrest, Alex Puxty, John Kinsella, Martin Shaw
PURPOSE: This study aimed to establish which prognostic scoring tool provides the greatest discriminative ability when assessing critically ill cirrhotic patients in a general intensive care unit (ICU) setting. METHODS: This was a 12-month, single-centered prospective cohort study performed in a general, nontransplant ICU. Forty clinical and demographic variables were collected on admission to calculate 8 prospective scoring tools. Patients were followed up to obtain ICU and inhospital mortality...
December 2014: Journal of Critical Care
J C Lopez-Delgado, F Esteve, C Javierre, H Torrado, M L Carrio, D Rodríguez-Castro, E Farrero, J Lluís Ventura, R Manez
AIM: Little is known regarding the long-term outcome in cirrhotic patients undergoing cardiac surgery. The objective of this study was to identify preoperative and postoperative mortality risk factors and to determine the best predictors of long-term outcome. METHODS: Fifty-eight consecutive cirrhotic patients requiring cardiac surgery between January 2004 and January 2009 were prospectively studied at our institution. Seven patients (12%) died. A complete follow-up was performed in the whole survival group until November 2012 (mean 46±28 months)...
August 2015: Journal of Cardiovascular Surgery
Eleni Theocharidou, Giulia Pieri, Ali Omar Mohammad, Michelle Cheung, Evangelos Cholongitas, Banwari Agarwal, Agarwal Banwari, Andrew K Burroughs
OBJECTIVES: Prognosis for patients with cirrhosis admitted to intensive care unit (ICU) is poor. ICU prognostic models are more accurate than liver-specific models. We identified predictors of mortality, developed a novel prognostic score (Royal Free Hospital (RFH) score), and tested it against established prognostic models and the yet unvalidated Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) model. METHODS: Predictors of mortality were defined by logistic regression in a cohort of 635 consecutive patients with cirrhosis admitted to ICU (1989-2012)...
April 2014: American Journal of Gastroenterology
Jeremie Rousseaux, Bruno Grandbastien, Aimée Dorkenoo, Marie Emilie Lampin, Stéphane Leteurtre, Francis Leclerc
OBJECTIVES: Septic shock is frequent in children and is associated with high mortality and morbidity rates. Early recognition of severe sepsis improve outcome. Shock index (SI), ratio of heart rate (HR) and systolic blood pressure (SBP), may be a good noninvasive measure of hemodynamic instability that has been poorly studied in children. The aim of the study was to explore the usefulness of SI as an early index of prognosis for septic shock in children. METHODS: The study was retrospective and performed in 1 pediatric intensive care unit at a university hospital...
October 2013: Pediatric Emergency Care
Loren Reed, Jennifer Carroll, Antonio Cummings, Stephen Markwell, Jarrod Wall, Myto Duong
OBJECTIVES: No single reliable sepsis biomarker exists for risk stratification and prognostication in pediatric patients presenting to the emergency department (ED). Serum lactate (LA) predicts mortality in septic adults. We sought to determine if serum LA correlated with the diagnosis of sepsis, admission rates, and outcomes in pediatric patients presenting to the ED with suspected infection. METHODS: This retrospective study was performed in an ED with a sepsis protocol that included serum LA with every blood culture...
July 2013: Pediatric Emergency Care
Young A Kim, Eun-Ju Ha, Won Kyoung Jhang, Seong Jong Park
PURPOSE: We attempted to evaluate whether the early lactate area is useful as an early prognostic marker of mortality in pediatric septic shock patients. METHODS: We performed a retrospective study of pediatric patients with septic shock who were admitted to the pediatric intensive care unit of Asan Medical Center, Seoul, Korea. Serial arterial lactate levels were obtained immediately and then every 6 h after admission for a total of 24 h. The lactate area (mmol/lh) was defined as the sum of the area under the curve (AUC) of serial lactate levels measured during the 24 h following admission...
October 2013: Intensive Care Medicine
Juan Carlos Lopez-Delgado, Francisco Esteve, Casimiro Javierre, Xose Perez, Herminia Torrado, Maria L Carrio, David Rodríguez-Castro, Elisabet Farrero, Josep Lluís Ventura
OBJECTIVES: Cirrhosis represents a serious risk in patients undergoing cardiac surgery. Several preoperative factors identify cirrhotic patients as high risk for cardiac surgery; however, a patient's preoperative status may be modified by surgical intervention and, as yet, no independent postoperative mortality risk factors have been identified in this setting. The objective of this study was to identify preoperative and postoperative mortality risk factors and the scores that are the best predictors of short-term risk...
March 2013: Interactive Cardiovascular and Thoracic Surgery
Jan Martin, Manfred Blobner, Raymonde Busch, Norman Moser, Eberhard Kochs, Peter B Luppa
BACKGROUND: The aim of the study was to retrospectively investigate whether parameters of routine point-of-care testing (POCT) predict hospital mortality in critically ill surgical patients on admission to the intensive care unit (ICU). METHODS: Arterial blood analyses of 1551 patients on admission to the adult surgical ICU of the Technical University Munich were reviewed. POCT was performed on a blood gas analyser. The association between acid-base status and mortality was evaluated...
February 2013: Clinical Chemistry and Laboratory Medicine: CCLM
Tanya Doherty, David Sanders, Debra Jackson, Sonja Swanevelder, Carl Lombard, Wanga Zembe, Mickey Chopra, Ameena Goga, Mark Colvin, Lars T Fadnes, Ingunn M S Engebretsen, Eva-Charlotte Ekström, Thorkild Tylleskär
BACKGROUND: Breastfeeding is a critical component of interventions to reduce child mortality. Exclusive breastfeeding practice is extremely low in South Africa and there has been no improvement in this over the past ten years largely due to fears of HIV transmission. Early cessation of breastfeeding has been found to have negative effects on child morbidity and survival in several studies in Africa. This paper reports on determinants of early breastfeeding cessation among women in South Africa...
2012: BMC Pediatrics
Adnan Tas, Erdem Akbal, Yavuz Beyazit, Erdem Kocak
BACKGROUND: Cirrhotic patients admitted to the intensive care unit (ICU) usually have multi-organ failure. Multiple organ failure entails a very poor outcome in all intensive care patients. Cirrhotic patients show high morbidity and mortality rates compared with other critically ill patients. Severity scores have been developed for cirrhotic patients admitted to ICU. The main aim of this study was to determine whether lactate level gives any predictive value for mortality in cirrhotic elderly patients admitted to the ICU...
August 2012: Wiener Klinische Wochenschrift
Jean-Paul Cervoni, Thierry Thévenot, Delphine Weil, Emilie Muel, Olivier Barbot, Frances Sheppard, Elisabeth Monnet, Vincent Di Martino
BACKGROUND & AIMS: We aimed at improving prediction of short-term mortality in cirrhotic inpatients by evaluating C-reactive protein (CRP) as a surrogate marker of systemic inflammatory response syndrome (SIRS). METHODS: One-hundred and forty-eight consecutive cirrhotic patients with Child-Pugh score ≥ B8 and without hepatocellular carcinoma were prospectively included and followed for 182 days. The primary end point was 6-month survival. RESULTS: Main baseline characteristics were as follows: alcoholic liver disease in 88...
June 2012: Journal of Hepatology
Bharat Ramakrishna, Stephen M Graham, Ajib Phiri, Limangeni Mankhambo, Trevor Duke
OBJECTIVES: To determine whether blood lactate measured at the time of presentation to hospital predicted outcome in children with pneumonia in Malawi, and to understand the factors associated with high blood lactate concentrations in pneumonia. DESIGN: Analysis of data from a prospective study of children presenting to Queen Elizabeth Central Hospital, Blantyre, with WHO-defined severe or very severe pneumonia. RESULTS: Among 233 children with pneumonia, the median serum lactate concentration was 2...
April 2012: Archives of Disease in Childhood
Jian-Feng Wu, Rong-Yao Wu, Juan Chen, Bin Ou-Yang, Min-Ying Chen, Xiang-Dong Guan
BACKGROUND: Initial poor graft function (IPGF) following orthotopic liver transplantation is a major determinant of postoperative survival and morbidity. Lactate clearance is a good marker of liver function. In this study, we investigated the clinical utility of early lactate clearance as an early and accurate predictor for IPGF following liver transplantation. METHODS: This was a prospective observational study of 222 patients referred to the surgical intensive care unit (SICU) after orthotopic liver transplantation...
December 2011: Hepatobiliary & Pancreatic Diseases International: HBPD INT
Roberto F Machado, Mariana Hildesheim, Laurel Mendelsohn, Alan T Remaley, Gregory J Kato, Mark T Gladwin
Epidemiological studies support a hypothesis that pulmonary hypertension (PH) is a common complication of sickle cell disease (SCD) that is associated with a high risk of death and evolves as a complication of haemolytic anaemia. This fundamental hypothesis has been recently challenged and remains controversial. In order to further test this hypothesis in a large and independent cohort of SCD patients we obtained plasma samples from the Cooperative Study of Sickle Cell Disease (CSSCD) for analysis of a biomarker, N-terminal-pro brain natriuretic peptide (NT-proBNP), which is elevated in the setting of pulmonary arterial and venous hypertension...
August 2011: British Journal of Haematology
Ayşe Baysal, Ahmet Saşmazel, Ayşe İnci Yıldırım, Tuncer Koçak, Hasan Sunar, Rahmi Zeybek
OBJECTIVES: We evaluated the effects of thyroid hormone levels and interleukin-8 levels on prognosis in patients undergoing congenital heart surgery under cardiopulmonary bypass (CPB). STUDY DESIGN: The study included 41 consecutive children (19 boys, 22 girls; mean age 3.4 ± 3.1 years; range 0.3 to 12 years). The patients were divided into two groups based on the presence or absence of postoperative low cardiac output state (LCOS). The definition of LCOS included oliguria, tachycardia, metabolic acidosis, and increased plasma lactate level...
December 2010: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Ramzi Jeddi, Mériem Achour, Ramzi Ben Amor, Lamia Aissaoui, Walid Bouterâa, Karima Kacem, Raihane Ben Lakhal, Héla Ben Abid, Zaher BelHadjAli, Amel Turki, Balkis Meddeb
Severe sepsis defined as infection-induced organ dysfunction or hypoperfusion abnormalities predispose to septic shock and increased mortality in neutropenic setting. We aimed at determining predictors of severe sepsis in neutropenic patients. Between 1 October and 31 December 2007, 41 patients (21 with acute myeloid leukemia, 19 with acute lymphoid leukemia and one with autologous stem cell transplantation for a mantle cell lymphoma) with chemotherapy-induced neutropenia (<0.5 x 10(9)/l) lasting for more than 7 days were included in this study...
February 2010: Hematology (Amsterdam, Netherlands)
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