Association between the lactate-albumin ratio and microcirculation changes in Pediatric Septic patients

A lactate/albumin ratio (LAR) greater than 0.5 measured early in the course of pediatric critical illness is associated with greater mortality. Whether the elevated LAR can be explained by microcirculation disorders in children with sepsis is not known. In this longitudinal retrospective study (Janu...

Full description

Saved in:

Bibliographic Details
Published in:	Scientific reports Vol. 14; no. 1; pp. 22579 - 9
Main Authors:	Pérez, Maria Camila, Fernández-Sarmiento, Jaime, Bustos, Juan David, Ferro-Jackaman, Sarah, Ramírez-Caicedo, Paula, Nieto, Andrés, Lucena, Natalia, Barrera, Sofia, Fernández-Rengifo, José Manuel, Cárdenas, Carolina, Garavito, Maria Camila, Fernández-Sarta, Juan Pablo, Rotta, Isabella La, Coutin, Alejandro, Patiño, Juanita, Acevedo, Lorena, Suárez, Juan David, Duque-Arango, Catalina
Format:	Journal Article
Language:	English
Published:	London Nature Publishing Group UK 29-09-2024 Nature Publishing Group Nature Portfolio
Subjects:	692/1807 692/308 692/4019 692/499 692/53 Albumin Biomarkers - blood Blood flow Child Child, Preschool Children Female Fluid bolus Humanities and Social Sciences Humans Infant Intensive Care Units, Pediatric Lactic acid Lactic Acid - blood Longitudinal Studies Male Microcirculation Microvasculature Mortality multidisciplinary Pediatrics Retrospective Studies Science Science (multidisciplinary) Sepsis Sepsis - blood Septic shock Serum Albumin - analysis Serum Albumin - metabolism Shock, Septic - blood Sepsis Septic shock Children Fluid bolus Mortality
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	A lactate/albumin ratio (LAR) greater than 0.5 measured early in the course of pediatric critical illness is associated with greater mortality. Whether the elevated LAR can be explained by microcirculation disorders in children with sepsis is not known. In this longitudinal retrospective study (January 2021-January 2024), serum albumin and lactate were measured on admission to the pediatric intensive care unit (PICU), with sublingual video microscopy performed simultaneously to measure microcirculation. A total of 178 children were included, 37% of whom had septic shock measured with the Phoenix Sepsis Score. Patients with remote sepsis had greater odds of an elevated LAR (aOR 6.87: 95% CI 1.98–23.73; p < 0.01). Children with an elevated LAR had more microvascular blood flow abnormalities (aOR 1.31 95% CI 1.08–1.58; p < 0.01), lower 4-6-micron capillary density (aOR 1.03 95% CI 1.01–1.05; p < 0.01) and greater odds of dying (aOR 3.55 95% CI 1.21–10.38; p = 0.02) compared to those with a low LAR. We found no association between LAR and endothelial glycocalyx degradation. A normal LAR is associated with less risk of microcirculatory injury (aOR 0.77 95% CI 0.65–0.93; p < 0.01). In children with sepsis, an elevated LAR is associated with microcirculation abnormalities (microvascular density and flow). The lactate/albumin ratio is a potentially useful biomarker for microcirculatory injury in sepsis.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2045-2322 2045-2322
DOI:	10.1038/s41598-024-73112-5