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BOSTON — Initial serum lactate measurements are not reliable predictors of major injuries in children with severe blunt trauma, based on data from a prospective study of 200 children in a university pediatric emergency department.
Serum lactate levels are often used to measure tissue hypoperfusion in adult sepsis patients and in trauma patients who don't show signs of shock. “Elevated blood lactate reflects anaerobic metabolism due to hypoperfusion,” Dr. Antonio E. Muniz said at the annual meeting of the American Academy of Emergency Physicians.
Dr. Muniz of the University of Texas Health Sciences Center at Houston reviewed serum lactate levels in children aged 2–18 who had suffered blunt trauma. Serum lactate levels were elevated in 56 (28%) of the children. For predicting the 102 major injuries, the sensitivity of elevated lactate was 47% and the specificity was 86%, suggesting that initial levels of serum lactate are not helpful, he noted. The positive predictive value was 71%, and the negative predictive value was 68%.
Extremity fractures accounted for about 25% of the major injuries. Other types of major injuries included facial fracture, pelvic fracture, liver laceration, and spleen laceration. Most of the blunt trauma injuries were caused by motor vehicle accidents (152 children), followed by being hit by a car (24 children), falls (12 children), bicycle accidents (8 children), and gunshot wounds (4 children).
Data from other studies suggest that measuring serum lactate at later intervals after blunt trauma might be useful for assessing injuries, Dr. Muniz noted. He had no financial conflicts to disclose.
BOSTON — Initial serum lactate measurements are not reliable predictors of major injuries in children with severe blunt trauma, based on data from a prospective study of 200 children in a university pediatric emergency department.
Serum lactate levels are often used to measure tissue hypoperfusion in adult sepsis patients and in trauma patients who don't show signs of shock. “Elevated blood lactate reflects anaerobic metabolism due to hypoperfusion,” Dr. Antonio E. Muniz said at the annual meeting of the American Academy of Emergency Physicians.
Dr. Muniz of the University of Texas Health Sciences Center at Houston reviewed serum lactate levels in children aged 2–18 who had suffered blunt trauma. Serum lactate levels were elevated in 56 (28%) of the children. For predicting the 102 major injuries, the sensitivity of elevated lactate was 47% and the specificity was 86%, suggesting that initial levels of serum lactate are not helpful, he noted. The positive predictive value was 71%, and the negative predictive value was 68%.
Extremity fractures accounted for about 25% of the major injuries. Other types of major injuries included facial fracture, pelvic fracture, liver laceration, and spleen laceration. Most of the blunt trauma injuries were caused by motor vehicle accidents (152 children), followed by being hit by a car (24 children), falls (12 children), bicycle accidents (8 children), and gunshot wounds (4 children).
Data from other studies suggest that measuring serum lactate at later intervals after blunt trauma might be useful for assessing injuries, Dr. Muniz noted. He had no financial conflicts to disclose.
BOSTON — Initial serum lactate measurements are not reliable predictors of major injuries in children with severe blunt trauma, based on data from a prospective study of 200 children in a university pediatric emergency department.
Serum lactate levels are often used to measure tissue hypoperfusion in adult sepsis patients and in trauma patients who don't show signs of shock. “Elevated blood lactate reflects anaerobic metabolism due to hypoperfusion,” Dr. Antonio E. Muniz said at the annual meeting of the American Academy of Emergency Physicians.
Dr. Muniz of the University of Texas Health Sciences Center at Houston reviewed serum lactate levels in children aged 2–18 who had suffered blunt trauma. Serum lactate levels were elevated in 56 (28%) of the children. For predicting the 102 major injuries, the sensitivity of elevated lactate was 47% and the specificity was 86%, suggesting that initial levels of serum lactate are not helpful, he noted. The positive predictive value was 71%, and the negative predictive value was 68%.
Extremity fractures accounted for about 25% of the major injuries. Other types of major injuries included facial fracture, pelvic fracture, liver laceration, and spleen laceration. Most of the blunt trauma injuries were caused by motor vehicle accidents (152 children), followed by being hit by a car (24 children), falls (12 children), bicycle accidents (8 children), and gunshot wounds (4 children).
Data from other studies suggest that measuring serum lactate at later intervals after blunt trauma might be useful for assessing injuries, Dr. Muniz noted. He had no financial conflicts to disclose.