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    Mar 04, 2021
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    Evaluating lactate prognostic value in children suspected of acetaminophen-induced liver failure in Liberia

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    Authors
    Haidar, MK
    Morton, N
    Roederer, T
    Mayronne, S
    Bawo, L
    Kerkula, J
    Porten, K
    Baud, FJ
    Issue Date
    2020-01-29
    Submitted date
    2020-02-06
    
    Metadata
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    Journal
    Pediatric Research
    Abstract
    BACKGROUND: The prognostic significance of hyperlactatemia in young children with liver injury suspected to be attributed to repeated supratherapeutic doses of acetaminophen remain understudied. METHODS: We conducted a retrospective medical chart review including children aged <5 years admitted with hepatocellular injury. The study was conducted in Bardnesville Junction Hospital operated by Médecins Sans Frontières in Monrovia, Liberia. RESULTS: We analyzed 95 children with liver injury in whom a blood lactate measurement on admission was available. Eighty children (84%) were aged <2 years; 49 children (52%) died during hospitalization. The median acetaminophen concentration on admission was 20 mg/L with 60 (70%) children presenting concentrations exceeding 10 mg/L. Median lactate was significantly higher in children who died (10.7 mmol/L; interquartile range (IQR): 8.5-15.7) than those who survived (6.1 mmol/L; IQR: 4.1-8.5), P value < 0.001). The optimal threshold obtained was 7.2 mmol/L with a sensitivity of 84% and specificity 70% (area under curve = 0.80). The previously established thresholds of 3.5 and 4 mmol/L lactate had very low specificity identifying non-survival in children included in this study. CONCLUSION: In this setting, young children with ALF possibly attributed to acetaminophen toxicity were unlikely to survive if the venous blood lactate concentration exceeded 7.2 mmol/L.
    Publisher
    Springer Nature
    URI
    http://hdl.handle.net/10144/619600
    DOI
    10.1038/s41390-020-0783-z
    PubMed ID
    31995809
    Language
    en
    Description
    We regret that this article is behind a paywall.
    ISSN
    1530-0447
    ae974a485f413a2113503eed53cd6c53
    10.1038/s41390-020-0783-z
    Scopus Count
    Collections
    Paediatrics

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