Shock Index and Baseline Lactate Level did not Predict Nonsurvival in Pediatric Patients with Severe Sepsis: A tertiary hospital experience

Abdelaziz, Tarek A.; Karam, Nehad Ahmed; Ibrahim Ismail, Weaam; Ali Askary, Nahed Mohamed

doi:10.21608/zumj.2023.227362.2840

	Shock Index and Baseline Lactate Level did not Predict Nonsurvival in Pediatric Patients with Severe Sepsis: A tertiary hospital experience
Zagazig University Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 21 August 2023
Document Type: Original Article
DOI: 10.21608/zumj.2023.227362.2840
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Authors
Tarek A. Abdelaziz ¹; Nehad Ahmed Karam²; Weaam Ibrahim Ismail³; Nahed Mohamed Ali Askary ¹
¹Pediatrics department, Faculty of Medicine, Zagazig University, Zagazig, Egypt
²Professor of Pediatrics Faculty of Medicine, Zagazig University, Egypt
³Clinical pathology department, Zagazig faculty of medicine ,Zagazig university
Abstract
Background: Limited information exists regarding the shock index (SI) and lactate levels in children with sepsis. Therefore, we performed this study to explore the predictive value of SI (baseline and 6 h later) and baseline lactate levels in pediatric patients with severe sepsis. Methods: Children with severe sepsis were enrolled in this prospective study. The SI (measured by HR/SBP) and lactate levels were assessed. The study population was categorized into two distinct groups: survivors and nonsurvivors. Results: The sample size was 46 children, with 21 being survivors and 25 being nonsurvivors. Blood cultures in the survivors revealed Klebsiella pneumoniae and Escherichia coli (E. coli). However, blood cultures in the nonsurvivors revealed Klebsiella pneumonia and Acinetobacter baumannii complex. The SI did not significantly differ between survivors and nonsurvivors. The median (IQR) lactate levels of survivors were 5.2 (2.7 – 14) mmol/L, and those of nonsurvivors were 5.2 (3.1 – 18) mmol/L. The groups' baseline lactate levels did not differ significantly. Conclusions: We conclude that the shock index and lactate values do not vary notably between survivors and nonsurvivors. Therefore, the shock index (baseline and 6 h later) and baseline lactate levels did not predict nonsurvival in children with severe sepsis. This could be attributed to the limited number of study participants, large variations in normal physiological indicators, and limited pediatric physiological compensatory abilities in response to the shock.
Keywords
children; lactate; nonsurvivors; sepsis; shock index


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