Arterial blood lactate levels for short-term prognosis assessment following neonatal asphyxia resuscitation: A single-center retrospective study.

BACKGROUND

Arterial blood gas analysis can be utilized to detect neonatal acidosis and assess the condition of neonatal asphyxia. We conducted a retrospective single-center study to evaluate arterial lactate as a means to assess the risk of mortality following neonatal asphyxia resuscitation.

METHODS

Sixty-three cases of neonates undergoing resuscitation following asphyxia were included in the study. Radial arterial blood was collected according to standard procedures. Neonatal morbidity was recorded under at least one of the following conditions: Apgar score of 7 or less at 5 min after delivery, requirement for admission to the neonatal intensive care unit (NICU), and implementation of resuscitation. Logistic regression analysis was employed to study the relationship between blood gas analysis parameters and patient outcomes. We also evaluated the correlation between lactate levels and 5-min Apgar scores. Additionally, receiver operating characteristic (ROC) curves were used to assess the predictive capability of lactate in neonatal mortality following asphyxia resuscitation. Lastly, Kaplan-Meier survival curves were utilized to differentiate survival rates among different patient groups.

RESULTS

After adjusting for confounding factors, lactate was found to be an independent risk factor for mortality (OR = 24.70, 95% CI [2.66-2.23 × 10E+3]). Lactate levels and 5-min Apgar scores are negatively correlated (p < 0.05). The lactate area under the curve (AUC) for predicting neonatal mortality following resuscitation was 0.92, with a cutoff value of 6.85, corresponding to a sensitivity of 91.67 and specificity of 80.39. Kaplan-Meier survival curve analysis indicated higher mortality rates in patients with elevated lactate levels.

CONCLUSION

Arterial lactate levels provide valuable insights for assessing short-term mortality risk following neonatal asphyxia resuscitation. These findings support the consideration of lactate as an early prognostic indicator, aiding in the evaluation and management of neonates at risk of adverse outcomes.