Comparación de los niveles de ácido láctico en sangre con el PIM III como predictores precoces de mortalidad en pacientes ingresados en la unidad de cuidados intensivos del Hospital Roberto Gilbert Elizalde.

Abstract

Background: The care of critically ill patients is carried out in the intensive care units, which are exposed to a high risk of dying. As a result, assessment systems have been created that allow predicting the risk of mortality. Both blood lactate levels and the Pediatric Index of Mortality Score (PIM III), are close to the ideal predictor, and have been used to assess mortality in intensive care units. The purpose of this study is to make a comparison with the serum lactate and mortality score in patients admitted to the pediatric intensive care unit of the "Roberto Gilbert Elizalde Hospital" in the city of Guayaquil, who meet the inclusion criteria. Methods: The present investigation is a longitudinal, descriptive, observational and prospective study with epidemiological design, in 574 patients who entered the Pediatric Intensive Care Area at the Roberto Gilbert Hospital of the City of Guayaquil, of which 475 patients met the criteria of Inclusion and exclusion. Results: In this period 574 patients entered, of which 475 patients met the inclusion criteria corresponding to 82.7%, however, 17.3% corresponding to 99 patients were excluded due to chronic diseases. on the mortality in the PICU of the 475 patients, 11.7% presented with death, compared to a survival rate of 88.3%. The PIM 3 as lactate are good predictors of mortality, in this study it seems that when the PIM 3 at admission is greater than 40%, the risk of death is equal when a serum lactate greater than 4 mmol / L is reported. Conclusions: The PIM 3 and lactate was performed during the first hour of admission in the intensive therapy, 8 variables were applied between clinical and laboratory, concluding that the score of the pediatric mortality index (PIM 3) and the lactic acid have an acceptable value predictive at the time of admission to intensive pediatric therapy. Thus, the predictive capacity of PIM 3 is the same as lactic acid.