Serum lactate levels predict outcomes in children with moderate to severe traumatic brain injury
Traumatic brain injury (TBI) is one of the leading causes of death and disability among children worldwide. To ensure that children with TBI experience optimal outcomes, physicians aim to quickly identify children at the highest risk of morbidity and mortality so that they can provide immediate clinical intervention. In recent years, researchers have identified serum lactate as a potential method for assessing children’s risk after injury. The body produces serum lactate when cells consume glucose and water to produce energy. Serum lactate levels may become abnormal when cell metabolism is disrupted as a result of injury, enabling clinicians to identify tissue damage.
A team of researchers in China studied serum lactate levels as a predictor of children’s risk and outcomes following moderate to severe TBI. They reviewed hospital records from 213 children who were admitted to a pediatric trauma center between 2012 and 2018, finding that:
- Children with elevated serum lactate levels at the time of hospital admission were less likely to survive their injuries, compared to children with normal levels.
- Elevated serum lactate was associated with poorer outcomes on the Glasgow Coma Scale (GCS), a commonly used measure of TBI severity.
- Children with higher serum lactate at the time of hospital admission were more likely to need a mechanical ventilator to breathe.
- They also spent more time in the intensive care unit and were more likely to be re-hospitalized in the month following their initial injury.
The results of this study indicate that serum lactate levels are an effective predictor of children’s mortality and outcomes after moderate to severe TBI. Clinicians are advised to consider using serum lactate levels as a prognostic tool to identify high-risk children who need swift, intensive intervention for TBI.
Fu Y, Bai K, & Liu C. The impact of admission serum lactate on children with moderate to severe traumatic brain injury. PLoS One. (2019.)