Abstract：[Obj ective]To explore the correlation between serum lactate level and the prognosis in children with sep-sis.[Methods]According to serum lactate level in pediatric intensive care unit(PICU)within 24h,365 children with sep-sis in PICU of our hospital were divided into severely elevated group (≥4mmol/L,n=47 ),mildly elevated group (2mmol/L≤lactate<4mmol/L,n=108)and normal group(<2mmol/L,n=210).The correlation of serum lactate level and 6h-lactate clearance rate with disease severity and prognosis of pediatric patients with sepsis was analyzed.[Re-sults]The incidence of severe sepsis or septic shock in severe lactate elevation group,mild lactate elevation group and nor-mal group was 48.54%,37.23% and 14.25%(P<0.05)respectively.The incidence multiple organ dysfunction syn-drome in 3 groups was 45.34%,32.15% and 13.67%(p<0.05)respectively.The lactate levels in septic shock group, severe sepsis group and general sepsis group were 4.00±3.851mmol/L,2.98±2.537mmol/L and 1.85±1.523mmol/L respectively,and there was significant difference(H=38.551,P=0.000).The 6h-lactate clearance rate of 3 groups was (8.01±0.703)%,(12.34±15.89)% and (22.28 ± 14.46)% respectively,and there was significant difference(H=15.008,P=0.000).Lactic acid was gadually decreased at admission,admission 24 hours and 48 hours of admission,but the difference was no statistically significant (P>0.05).Lactate level in survival group and death group on admission were 2.085±1.669mmol/L and 4.27±4.135mmol/L respectively,and there was significant difference(u=4424.00,P=0.002).Serum lactate levels of survival children at 1,2 and 3 days had the decreasing trend,while those of death or a-bandoned children had the increasing trend(P<0.05).The mortality in low lactate clearance rate group was obviously higher than that in high lactate clearance rate group,and there was significant difference(P<0.05).[Conclusion]The dynamic monitoring of the changes of lactate and lactate clearance rate is conducive to grasp the condition and prognosis of patients.
2014, Vol. 31 
