Secondary analysis of the 2021–2023 Sepsis Epidemiology in Australian and New Zealand Children Observational Dataset: Association Between Presenting Venous Lactate Concentration and 72-Hour Outcomes

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In children hospitalized with suspected community-acquired sepsis, an initial venous lactate concentration of 3.5 mmol/L or greater has an acceptable-to-fair association with the subsequent need for extracorporeal life support or death within 72 hours. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Elliot Long; Stephen Hearps; Warwick Butt; Tom Rozen; James Williams; Amanda Williams; Ben Gelbart; Sarah McNab; Meredith L. Borland; Jarrod Cross; Shefali Jani; Marino Festa; Eunicia Tan; Natalie Phillips; Sainath Raman; Amit Kochar; Subodh Ganu; Simon Craig; Anna Lithgow; Emma Whyte; Arjun Rao; Stuart R. Dalziel; Shane George; Franz E. Babl

doi:10.1097/pcc.0000000000004055

Key Points

To determine whether initial venous lactate concentration measured upon hospital presentation is associated with extracorporeal life support or death within 72 hours in children with suspected sepsis.
Conducted a planned secondary analysis of the multicenter SENTINEL study across 11 emergency departments in Australia and New Zealand from 2021 to 2023.
Analyzed initial venous lactate drawn within 4 hours of arrival in N=4,806 children aged 0 to <18 years (median age 1.9 yr, 55.2% male) admitted with suspected sepsis.
The primary composite outcome of ECLS or death within 72 hours occurred in 33 of 4,806 children (0.7%).
An initial venous lactate threshold of ≥3.5 mmol/L identified 24 of the 33 critical events, showing a sensitivity of 72.7% (95% CI, 54.5–86.7%), specificity of 84.9% (95% CI, 83.9–85.9%), and an AUC of 0.79 (95% CI, 0.71–0.87).
Venous lactate ≥3.5 mmol/L shifted the pretest probability of ECLS or death from 0.7% to a posttest probability of 3.2%.

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Implication

Multicenter observational study demonstrates that initial venous lactate concentration predicts critical 72-hour outcomes in pediatric sepsis, highlighting its utility in early risk stratification.

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Long et al. (2026) studied this question.

synapsesocial.com/papers/6aa913909013453be30a19f7 https://doi.org/10.1097/pcc.0000000000004055

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Secondary analysis of the 2021–2023 Sepsis Epidemiology in Australian and New Zealand Children Observational Dataset: Association Between Presenting Venous Lactate Concentration and 72-Hour Outcomes

Key Points

No abstract yet

Implication

Discussion

Cite This Study

Secondary analysis of the 2021–2023 Sepsis Epidemiology in Australian and New Zealand Children Observational Dataset: Association Between Presenting Venous Lactate Concentration and 72-Hour Outcomes

Key Points

No abstract yet

Implication

Discussion

Cite This Study

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