Lactate Clearance in Paediatric Trauma - 3 year retrospective study
Research type
Research Study
Full title
Is Lactate and lactate clearance an effective clinical marker of outcome for children with major trauma? - a three year retrospective study
IRAS ID
237400
Contact name
Lorraine Lawton
Contact email
Sponsor organisation
Kings College Hospital NHS Foundation Trust
Duration of Study in the UK
2 years, 7 months, 1 days
Research summary
Paediatric major trauma is well recognised as the leading cause of death and morbidity in children 16 years and under (American College of Surgeons 2012). In 2014, in England and Wales 1,511 children were recorded on TARN as to having had severe injury (defined as an Injury Severity Score (ISS) of greater than 9) (TARN 2015). The physiological response of the child to trauma can pose a diagnostic challenge resulting in over or under resuscitation (Shah et al. 2013). Recent adult studies (Bree et al. 2010, Nordmann et al. 2010) have demonstrated that serum lactate, and its trends can be use to indicate severity of injury and predict outcome. There is a paucity of paediatric data regarding the clinical significance of lactate readings in major trauma. It is intended to complete a retrospective study on clinical notes of children with severe injury. The objectives for this study are:
1. What is the relationship between:
a. The Initial Lactate reading and the Injury Severity Score?
b. The Peak Lactate reading and the Injury Severity Score?
c. The time to Lactate Clearance and the Injury Severity score?2. How are vital signs of heart rate, systolic blood pressure, respiratory rate related to Initial Lactate, Peak Lactate and Lactate Clearance time?
3. What is the relationship of the highest lactate reading and the time to lactate clearance in relation to mortality within 48 hours, and morbidity on discharge?
4. Is the early administration of resuscitation fluids, including whole blood and Fresh Frozen Plasma or Normal Saline, during the resuscitation phase associated with reduction in the time of lactate clearance?
REC name
London - London Bridge Research Ethics Committee
REC reference
18/LO/0775
Date of REC Opinion
1 Jun 2018
REC opinion
Favourable Opinion