The Role of Lactate and Other Laboratory Markers on Detection of Subtle Myocardial Dysfunction in Critically ill Children
DOI:
https://doi.org/10.3889/oamjms.2021.6319Keywords:
Lactate, Laboratory marker, Myocardial dysfunction, Critically ill, ChildrenAbstract
BACKGROUND: Critically ill patients have a high risk of developing life-threatening infections that can eventually lead to multi-organ failure. The cardiovascular system involvement could increase the mortality rate by 70-90%. Myocardial dysfunction is often accompanied by a state of metabolic acidosis, liver damage, kidney damage, and anemia. Therefore laboratory markers and elevated lactate levels may aid in the early assessment of a myocardial dysfunction
AIM: The aim of this study was to prove the role of lactate and other laboratory markers on detection of subtle myocardial dysfunction (SMD) in critically ill children admitted to the Pediatric Intensive Care Unit (PICU).
METHODS: An observasional cohort study in PICU Haji Adam Malik General Hospital, Medan. Assessment of complete blood count, kidney function, liver function, lactic acid, blood gas analysis, and troponin I within 48 hoursPICU admission. The results of the troponin value was said to be subtle myocardial dysfunction if the troponin I value is ≥ 0.4 ng/ml
RESULT: 55 subjects were recruited in this study, 23 subject (41.1%) with SMD. Laboratory marker in SMD that has significant finding were lactate, AST, ALT, Hemoglobin (p = 0.003; p = 0.028; p = 0.01; p = 0.001, repectively). High lactate ( > 2.5 ng/ml) could be used as a predictor for SMD with sensitivity 74% and specificity 72%. Subject with SMD has significant association with mortality (p <0.001).
CONCLUSION: Subtle myocardial dysfunction should be suspected in patient with blood lactate level > 2.5 ng/ml, with significant association between SMD and mortality.
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Copyright (c) 2021 Munar Lubis, Aridamuriany Dwiputri Lubis, Badai Buana Nasution (Author)
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