This study is an observational, prospective, cohort study conducted in an academic ED of a large tertiary care center. During the 2 years recruitment phase of the study, all pediatric patients with suspected sepsis presenting to the ED will be screened for possible enrollment by the treating physician. We will be measuring the lactate and albumin levels of patients who fit the inclusion criteria.
The aims of this study are to describe an association between the initial serum lactate level taken in the emergency department and the use of resuscitation interventions in the ED performed by the treating physician in pediatric patients with suspected sepsis, including amount of IV fluids received; to ccorrelate the initial lactate level with the patient’s morbidity (ex. organ dysfunction), mortality and length of hospital stay; to more accurately describe the characteristics of the pediatric patients with suspected sepsis presenting to the emergency department in Lebanon; and to ccompare the initial lactate level to the initial albumin level, measure the lactate to albumin ratio and to correlate the ratio with the patient’s morbidity, mortality and length of hospital stay.
Pediatric patients presenting to the Emergency Department of AUBMC
This study is an observational, prospective, cohort study conducted in an academic ED of a large tertiary care center. During the 2 years recruitment phase of the study, all pediatric patients with suspected sepsis presenting to the ED will be screened for possible enrollment by the treating physician. The physician will introduce the study and its objectives to the patient. The physician will then inform the research team of possible candidates via phone call/Pager. The research fellow will then obtain consent from the patient/caregiver who accepts to join the study. All clinical information will be extracted from the patient/patient’s caregivers, scanned charts and electronic laboratory reports by the fellow.
· Age <18 years old
· Patient presenting to the emergency department
· Patient received 20cc/kg of IV fluids over at the most 1 hour, in the emergency department
· The patient had blood drawn for labs
· The presence of one of the following:
- physician’s clinical suspicion of sepsis
- fulfillment of 2/4 SIRS criteria + suspected infection i.e meeting the published definition of sepsis
· Patients transferred from another hospital
· Patients who have a lactate measured prior to presentation
· Patients suffering from inborn errors of metabolism
· Patients whose goals of therapy were palliative
· Patients who got transferred to another institution before the lactate level was obtained