Haluk COKUGRAS, Fatih AYGÜN, Cansu DURAK, Fatih VAROL, Yıldız CAMCIOGLU

Laktat / Albümin Oranı, Kritik Hasta Çocuklarda Mortalite İçin Etkili Bir Belirleyicidir

Giriş: Kritik hasta çocukların prognozunu ve mortalitesini değerlendirmek için birçok öngörücü biyobelirteç geliştirilmiştir. Hiperlaktateminin kritik hastalarda mortalite ile ilişkili olması nedeniyle serum laktat seviyesi yaygın bir biyobelirteçtir. Önceki çalışmalar, serum albümin seviyesinin de faydalı bir biyobelirteç olduğunu göstermiştir. Bazı yeni makaleler, serum laktat ve albümin kombinasyonunun kritik hastalardaki ölüm oranlarını daha etkili bir belirleyicisi olduğunu ileri sürdü. Bu çalışmada laktat / albümin (L / A) oranının tek başına serum laktat seviyesinden daha iyi bir prognostik faktör olup olmadığını belirlemeyi amaçladık. Gereç ve yöntemler: Bu nedenle bu biyobelirteçler ile invaziv mekanik ventilasyon, invaziv olmayan mekanik ventilasyon desteği, inotropik ilaç ihtiyacı, akut böbrek hasarı, sürekli renal replasman tedavisi, mortalite ve hastanede kalış süresi arasındaki ilişkiyi geriye dönük olarak inceledik. Bulgular: Çalışmaya yaş ortalamaları 4.8 ± 5.3 yıl (1 ay ile 18 ay arasında değişen) 379 hasta dahil edildi. Pediatrik yoğun bakım ünitesinde ortalama kalış süresi 7.4 ± 11.5 gün, ortanca L / A oranı 0.46 (dağılım, 0.11-10.0) idi. Bulgularımız kritik hasta çocuklarda L / A oranı ve serum laktat seviyesinin mortalite ile ilişkili olduğunu göstermektedir. Bununla birlikte, analiz sonuçlarımız > 0.5 L / A oranının genel olarak daha iyi bir mortalite belirleyicisi olduğunu düşündürmektedir. Sonuç: L / A oranının kritik hasta çocuklarda mortalitenin yararlı ve etkili bir belirleyicisi olduğu sonucuna vardık.

Anahtar Kelimeler:

Pediatrik yoğun bakım ünitesi, prognoz, laktat, albumin

The Lactate/Albumin Ratio is an Effective Predictor for Mortality in Critically Ill Children

Introduction: Many predictive biomarkers were developed to evaluate the prognosis and mortality of critically ill children. Serum lactate level is one common biomarker because hyperlactatemia is associated with mortality in these patients. Previous studies have shown that serum albumin level is also a useful biomarker. Several recent articles suggested that the combination of serum lactate and albumin is a more effective predictor of mortality in critically ill patients. This study aimed to determine whether the lactate/albumin (L/A) ratio was a better prognostic factor than serum lactate level alone. Material and Methods: Thus, we retrospectively investigated the relationship between these biomarkers and their relationship with invasive mechanical ventilation, noninvasive mechanical ventilation support, inotropic drug need, acute renal kidney injury, continuous renal replacement therapy, mortality, and hospitalisation period. Results: A total of 379 patients with a mean age of 4.8±5.3 years (range, 1 month to 18 years) were included in this study. The average duration of stay in the paediatric intensive care unit was 7.4±11.5 days, and the median L/A ratio was 0.46 (range, 0.11–10.0). Our findings indicate that the L/A ratio and serum lactate level were associated with mortality in critically ill children. However, our analysis also suggested that an L/A ratio of >0.5 upon admission is an overall better predictor of mortality. Conclusion:We conclude that the L/A ratio is a useful and effective predictor of mortality in critically ill children.

Keywords:

Paediatric intensive care unit, prognosis, lactate, albumin,

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