Correlation between prognosis and severity of neonatal septic shock and levels of lactate in arterial blood

Objective To investigate the diagnostic value of lactate level in arterial blood for the prognosis of neonatal septic shock. Methods Thirty newborns with septic shock admitted to Zhengzhou Children’s Hospital from January 2019 to June 2019 were selected. And they were divided into three groups according to shock degrees, mild shock group (n=12), moderate shock group (n=10), and severe shock group (n=8). The newborns were re-divided into good prognosis group (n=19) and poor prognosis group (n=11) according to the improvement after 6 hours of resuscitation treatment. The lactate level, lactate clearance rate and 24 hour mortality were analyzed retrospectively. Correlation between lactate level and shock severity, as well as the diagnostic value of lactate level for the prognosis were determined by Spearman and receiver operating characteristic curve. Results The improvement rate of mild shock group was higher than that of severe shock group 6 h after treatment (P<0.05). The level of lactate in mild shock group was lower than that in severe shock group before treatment (P<0.05). The level of lactate in mild shock group was the lowest 6 h and 12 h after treatment (P<0.05). The level of lactate was positively correlated with the degree of shock (P<0.05). At post-treatment 6 h and 12 h, the lactate level in the good prognosis group was lower than that in the poor prognosis group, and the lactate clearance rate was higher than that in the poor prognosis group (P<0.05). The lactate level pretreatment and 6 and 12 h post treatment had high sensitivity to prognostic prediction. Conclusions The lactate level in arterial blood is positively correlated with the severity of septic shock in neonates. Children with high lactate concentration suffer a higher risk of death. Therefore, lactate concentration can be used as a sensitive prognostic indicator for children with septic shock. Key words: Arterial blood lactate level; Neonatal septic shock degree; Prognosis; Diagnostic value