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

Year 2020, Volume: 14 Issue: 6, 493 - 499, 30.11.2020

Fatih Aygün Cansu Durak Fatih Varol Haluk Çokuğraş Yıldız Camcıoğlu

https://doi.org/10.12956/tchd.591883

Abstract

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.

Keywords

Pediatrik yoğun bakım ünitesi, prognoz, laktat, albumin

Supporting Institution

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Thanks

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

Abstract

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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