KADAR LAKTAT SERIAL SEBAGAI FAKTOR PROGNOSIS MORTALITAS PASIEN SEPSIS

Background: Sepsis is a major health problem among children in both developing and industrialized country as a leading cause of death. There are several biomarkers for pediatrics sepsis has been studied. Lactate in recent decades has been studied as a biomarker for critical ill, trauma and sepsis. Both elevated level of blood lactate in sepsis indices global tissue hypoxia, increasing of glycolisis, endotoxin effects and an anaerobic metabolism. Many studies showed both high level and increasing in serial blood lactate level associated with increasing risk of mortality in sepsis. Objective: to determine the association between serial blood lactate level and mortality in sepsis. We collected serial blood l Method: This observational prospective study was performed at Pediatrics Intensive Care Unit (PICU), Sardjito Hospital, Yogyakarta from July to November 2012. actate specimens of children with sepsis fulfilled criteria, at first admission followed by 6 and 24 hours later. The others examination, laboratory findings, and management of patient was documented during hospitalized. Outcome measured is mortality at the end of intensive care. Data were analyzed with bivariate and multivariate analysis. (50.2%) children from 181 PICU admitted. Only Result: Sepsis was found in 91 75 patient fulfilled the criteria and 5 patients died before 24 hours� lactate collected. Sepsis proven by positif culture was 57.3% for all cases, in 55 specimens. Septic shock was found in 25 patients (33.3%) and lactic acidosis was found in 57.3% patients. Thirty nine patients (52.0%) death during study. First admission and 24 hours of blood lactate level � 4 mmol/L associated with mortality (RR 2.9 95%CI 1.09-7.6