Clinical Value Of Blood Lactate And It’s Clearance Rate In Predicting The Prognosis Of Neonatal Sepsis

Objective:To explore the clinical value of blood lactate level in the prognosis of neonatal sepsis.Methods:Totally 301 cases of confirmed neonatal sepsis were enrolled for this study,the clinical data mainly include biochemical indicators such as lactate at admission,24-hour blood lactate,CRP,PCT,etc.We calculate the early lactate clearance rate.Premature and full-term babies were divided according to lactate levels at admission and different outcomes,and clinical data were compared,then we used logistic regression analysis to screen out the risk factors affecting the prognosis of neonatal sepsis,plotted the ROC curve and calculated the area under the curve,compared its value to the prognosis of neonatal sepsis,and determined the critical value.Results: In full-term babies,the mortality rate in the severely-elevated-lactate group(21.7%)was significantly higher than mild-elevated-lactate group(2.5%)and the normal-lactate group(0%)(P<0.05);Lactate level(6.5±5.1 mmol/L)in the poor-prognosis group were significantly higher than the good-prognosis group(3.6±1.7mmol/L)(P<0.05);the 24-hour lactate clearance rate(-0.43±2.04)was significantly lower in the poor prognosis group(P<0.05).The presence of microcirculatory disorders,CRP,and lactate levels at admission were significant risk factors for the prognosis of neonatal sepsis.The test of blood lactate level at admission was more sensitive and specific than the CRP level in the prognosis of neonatal sepsis.When the lactate reaches 6.15 mmol/L,the prognosis of the neonatal sepsis is more likely to be worse.Conclusion: Monitoring the blood lactate level plays an important role,and lactate level at admission can be used as a marker to predict the severity and prognosis of neonatal sepsis.