The Role of Lactate and Other Laboratory Markers on Detection of Subtle Myocardial Dysfunction in Critically ill Children

Abstract

BACKGROUND: Critically ill patients have a high risk of developing life-threatening infections that can eventually lead to multiorgan failure. The cardiovascular system involvement could increase the mortality rate by 70–90%. Myocardial dysfunction is often accompanied by a state of metabolic acidosis, liver damage, kidney damage, and anemia. Therefore, laboratory markers and elevated lactate levels may aid in the early assessment of myocardial dysfunction. AIM: The aim of this study was to prove the role of lactate and other laboratory markers on the detection of subtle myocardial dysfunction (SMD) in critically ill children admitted to the Pediatric Intensive Care Unit (PICU). METHODS: An observational cohort study in PICU Haji Adam Malik General Hospital, Medan. Assessment of complete blood count, kidney function, liver function, lactic acid, blood gas analysis, and troponin I (TnI) within 48 h PICU admission was perfored. The results of the troponin value were said to be SMD if the TnI value is ≥0.4 ng/ml. RESULTS: Fifty-five subjects were recruited in this study, 23 subject (41.1%) with SMD. Laboratory marker in SMD that has significant finding were lactate, aspartate aminotransferase, alanine aminotransferase, and hemoglobin (p = 0.003; p = 0.028; p = 0.01; p = 0.001, respectively). High lactate (>2.5 ng/ml) could be used as a predictor for SMD with sensitivity 74% and specificity 72%. Subject with SMD has significant association with mortality (p < 0.001). CONCLUSION: SMD should be suspected in a patient with blood lactate level >2.5 ng/ml, with significant association between SMD and mortality. Edited by: Igor Spiroski Citation: Lubis M, Lubis AD, Nasution BB. The Role of Lactate and Other Laboratory Markers on Detection of Subtle Myocardial Dysfunction in Critically ill Children. Open Access Maced J Med Sci. 2021 Jun 15; 9(T3):265-269. https://doi.org/10.3889/oamjms.2021.6319