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PS-186 Blood Lactate As A Predictive Marker For Neonatal Necrotising Enterocolitis (nec) Severity And Operative Outcomes
  1. AK Davenport,
  2. S Chuang,
  3. P Desai
  1. Neonatal Unit, Chelsea and Westminster NHS Foundation Trust, London, UK

Abstract

Background and aims Lactate as a marker for tissue perfusion and hypoxia is increasingly used in routine point-of-care monitoring in critical care. We investigated the association of pre-operative lactate (PreL) with operative outcomes and mortality in neonatal surgical NEC.

Methods 25 infants with NEC confirmed on laparotomy at a tertiary surgical centre were retrospectively evaluated. Maximal PreL was categorised as normal (<2 mmol/L), moderate (2–5 mmol/L) or severe (>5 mmol/L), and correlated to extent of NEC involvement and mortality.

Results Median birth gestation and weight were 27weeks (range 23–33) and 1035g (555–2060). Median PreL was 5.1(range 0.6–16.2)mmol/L. Elevated PreL correlated with NEC severity, with predominance of pan-intestinal and multifocal involvement in severe hyperlactaemia (Table 1). Infants with isolated NEC were observed to have normal or moderate-PreL. Moderate to severe PreL was also associated with increased mortality rate and need for further surgery.

Abstract PS-186 Table 1

Surgical outcomes and Preoperative lactate (PreL)

Conclusions This preliminary study suggests that pre-operative hyperlactaemia and degree of elevation may be associated with a poor prognosis in infants with surgical NEC. Further larger studies may enable better evaluation of its use an adjunctive monitoring or prognostic tool in guiding early neonatal NEC management.

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