Does lactate level in the first 12 hours of life predict mortality in extremely premature infants?

Abstract

Aims: To determine if high lactate levels within the first 12 h of life independently or in combination with Clinical Risk Index for Babies (CRIB) II can predict mortality in extremely premature babies.

Study design: A retrospective review of medical charts of babies born between 2001 and 2003 with birthweight <1000 g or gestation <28 weeks was performed. Blood gases and highest umbilical lactate levels in first 12 h of life were noted. Area under the curve (AUC) was calculated for lactate, CRIB and CRIB II as a predictor of mortality. The AUC for lactate and CRIB II were combined using discriminant analysis.

Results: Two hundred nineteen infants were included in the study, 41 (18.7%) of whom died. The AUC for lactate was 0.67 (P < 0.001), while AUCs for CRIB and CRIB II score were 0.81 (P < 0.001) and 0.82 (P < 0.001), respectively. The AUC for the combined measure of lactate and CRIB II was 0.82, similar to CRIB II.

Conclusions: Lactate predicts mortality in premature infants, but was found to be inferior to CRIB and CRIB II. Adding lactate level to CRIB II score does not improve its predictive ability.