PLASMA LACTATE AS A PREDICTOR OF EARLY-CHILDHOOD NEURODEVELOPMENTAL OUTCOME OF NEONATES WITH SEVERE HYPOXEMIA REQUIRING EXTRACORPOREAL MEMBRANE-OXYGENATION

Although plasma lactate concentration has been widely used as an indic ator of tissue hypoxia, no clinical study has been conducted to relate these values to the neurological outcome of sick neonates. Seventeen consecutively cared for and surviving neonates with severe hypoxaemia requiring extracorporeal membrane oxygenation (ECMO) were evaluated at a mean age of 19.6 months. The serial plasma lactate concentrations w ere significantly correlated with the scores of the Bayley Scales of I nfant Development. Admission and peak plasma lactate of less than or e qual to 15 mmol/1 predicted favourable outcome (MDI and PDI >70 and no disability): sensitivity 100%, specificity 88%, positive predictive v alue 90%, and negative predictive value 100%. Plasma lactate values co uld help predict neurodevelopmental outcome in these sick neonates.