الفهرس 
Critically Ill Child
Shock in Critically Ill ChildrenOnly 14 pages are availabe for public view
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Abstract
Summary & Conclusion
Lactic acid is produced as the normal end point of anaerobic
breakdown of glucose in the tissues for energy production in the setting
of decreased tissue oxygenation (Vernon C.2010).
The normal blood lactate concentration in un stressed patients is
0.5-1mmol /L. Patients with critical illness can be considered to have
normal lactate concentrations of less than 2mmol /L.
Hyperlactemia is defined as apersistent, mild to moderate (2-4
mmol /L) increase in blood lactate concentration without metabolic
acidosis, whereas lactic acidosis is characterized by persistently
increased blood lactate levels ( usually > 5mmol /L) in association with
metabolic acidosis. (Anderson, et al., 2015).
Lactic acidosis is caused by hypoxic causes; type (A) such as
(haematological causes,cardiac causes and respiratory causes.) and
non-hypoxic causes; type (B) such as (delayed clearance, renal or
hepatic dysfunction, and malignancies). (Fall. 2005).
Lactate clearance is thought to be more prognostic factor than
lactate level in predicting morbidity and mortality in critically ill
patients (Gracia- Alvarez M 2014).
The aim of this work is to correlate between lactate clearance
and outcome of critically ill patients.
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Summary & Conclusion
This study included 30 cases (15 males &15 females) admitted
to Tanta PICU during period of May 2016 to May 2017 , with the age
ranged from 3 up to 130 months .Patients with primary renal diseases,
primary liver diseases, inborn of error of metabolism and congenital
cyanotic heart diseases were excluded from this study and 30 control
healthy child .
Data were collected including history about diagnosis on
admission, hospital stay, need and duration of mechanical ventilation.
Severity of illness was assessed by using Pediatric Index of Mortality II
(PIM2). Clinical examination for all body systems, patient height &
weight were assessed. Samples for serum lactate were obtained at
admission and after 12 and 24 h from admission. ESR, blood culture,
CBC, PT, liver & renal functions and CRP were done routinely.
In this study it was found that there were no significant
differences between children who lived and others who died in relation
to age and sex, and weight (P value >0.05).
As regard to Pediatric Index of Mortality (PIM2), there was
significant difference between children who lived and others who died
(P value 0.05).
As regard to serial blood lactate level between survivors and
non-survivors.