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ISSN 1561-3119 (Electronic)

2016, Number 2

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Rev Cubana Pediatr 2016; 88 (2)

Lactic acid and SEGRAV-23 scale as predictive values of severity in critically-ill children

Fernández RF, Lescay VA, Francisco PJC, Machado BC

Language: Spanish
References: 27
Page: 156-165
PDF size: 108.58 Kb.


ABSTRACT

Introduction: the severity scoring systems are means to objectively quantify the patient's clinical situation, to determine the prognosis and to evaluate the efficacy and efficiency of the treatment. Lactate is a biomarker that has demonstrated its great predictive capacity for mortality, which keeps it included in the experts' recommendation and in all relevant guidelines.
Objective: to determine the severity prognosis of the lactic acid and of the index System for Evaluating the Severity of Diseases (SEGRAV-23) in children admitted to the pediatric intensive care unit in the period of February 2011 to February 2013.
Methods: prospective, longitudinal, analytical and observational study of 208 patients admitted to the pediatric intensive care units in “Dr Luis Diaz Soto” and “Juan Manuel Márquez” hospitals, conducted from February 2011 to February 2013. For the purpose of determining the level of dependence between the living and dead people in the SEGRAV-23 index and the lactate values, Pearson's chi square with p< 0.05 was used to assure 95 % reliability.
Results: regarding SEGRAV-23 and the lactate values, it was observed that 32.3 % of patients with 5-7 mmol/L lactate continued to be reported as severely-ill and 14.7 % as critical patients. In the group of dead people, 43.7 % had a SEGRAV-23 index higher than 21 scores whereas 35.3 % of patients with lactate values of 5 to 7 mmol/L on admission died. After ten days of hospitalization, it was evinced that 72.7 % of patients who had 5-7 mmol/L lactate values died as it happened with 80 % of those with over 7 mmol/L hyperlactoacidemia.
Conclusions: lactic acid and the SEGRAV-23 scale have acceptable prognostic capacity and are good severity indicators in critically-ill patients.


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