Can Lactate be Valuable in Early Diagnosis and Prognosis of Neonatal Sepsis?

Abstract

Background: Sepsis monitoring tissue perfusion is crucial for detecting circulatory failure early, implementing the right treatments, and  assessing response. Insufficient oxygenation leads to a rise in lactate level and has been shown to be useful in predicting mortality and  morbidity in newborns. There have not been many studies on how lactate measurement affects neonatal sepsis diagnosis and prognosis. 

Aim: The aim of our study was to determine the impact of lactate on early diagnosis and prognosis in neonatal sepsis.    

Materials and Methods: Eighty-seven newborns diagnosed with neonatal sepsis at a neonatal intensive care unit between January 2010  and July 2021 were included in the study. Venous blood gas, lactate, and C-reactive protein (CRP) levels and complete blood count on the  first, second, and third day of hospitalization were noted. Lactate values were correlated with other variables to determine the impact of  hyperlactatemia on morbidity and to determine factors affecting the length of stay. IBM SPSS Statistics version 22.0 for Windows was  used to analyze the data (SPSS Inc., Chicago, IL, United States).

Results: A strong negative correlation between lactate and oxygenation  and perfusion indicators (HCO₃ , BE, PaO₂ ) during the therapeutic process was observed. With treatment, the initial measured lactate  value decreased, and a significant increase in CRP and oxygen saturation was observed, which was interpreted as the observation of an  early lactate response to infection before a CRP response. The initial lactate level, as well as the change in lactate levels, was not, however,  significantly correlated with the length of stay.

Conclusion: Lactate can be used in the early diagnosis of neonatal sepsis and  for determining prognosis.