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Comment & Response
June 26, 2017

Venous vs Arterial Lactate and 30-Day Mortality in Pediatric Sepsis

Author Affiliations
  • 1Pediatric Critical Care Research Group, Mater Research Institute, University of Queensland, Brisbane, Australia
  • 2Pediatric Intensive Care Unit, Lady Cilento Children’s Hospital, Brisbane, Australia
  • 3Department of Pediatrics, Inselspital, University of Bern, Bern, Switzerland
  • 4Pediatric Intensive Care Unit, The Royal Children’s Hospital, Melbourne, Australia
  • 5Department of Pediatrics, University of Melbourne, Melbourne, Australia
  • 6Cardiothoracic Intensive Care Unit, National University Health System, Singapore
  • 7Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
JAMA Pediatr. Published online June 26, 2017. doi:10.1001/jamapediatrics.2017.1598

To the Editor Scott et al1 reported on 1299 children evaluated for suspected sepsis at a tertiary emergency department. They observed a 3-fold increase in 30-day mortality in children with a venous lactate level greater than 36 mg/dL (to convert to millimoles per liter, multiply by 0.111) in comparison with levels of 36 mg/dL or less. In this single-center study with a mortality rate of 1.9%, 7.9% of patients (n = 103 of 1299) had increased lactate levels at admission, and 20% of deaths (n = 5 of 25) occurred in this group. The authors demonstrated that early lactate measurements assist in the assessment of sepsis severity, thereby shedding light on the potential benefits of monitoring lactate as a marker of response to resuscitation.2

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