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I couldn’t locate that specific Journal of Paediatrics and Child Health study on paediatric oncology patients in intensive care, but here’s what insights current research offers on serum lactate levels in critically ill children — which likely apply to that group as well:
📈 Admission Lactate & Patient Outcomes
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Strong predictor of mortality:
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In large PICU cohorts, higher lactate at admission is significantly associated with increased in‑hospital mortality—even after adjusting for illness severity scores. For example, a study with 1,109 paediatric ICU patients reported an odds ratio (OR) per mmol/L of 1.27, with area under the ROC curve (AUC) ~0.79, nearly matching established scores like PRISM‑III (AUC ~0.82) (pubmed.ncbi.nlm.nih.gov, arxiv.org).
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A Chinese cohort of over 12,000 children found admission lactate independently linked to all‑cause mortality (adjusted OR 1.14 per mmol/L) (pmc.ncbi.nlm.nih.gov).
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Higher mortality by threshold:
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Pediatric sepsis data show that lactate ≥2.2 mmol/L correlates with a 3.6-fold increase in 28-day mortality (pmc.ncbi.nlm.nih.gov).
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Thresholds around 5–5.5 mmol/L at admission are linked to high mortality (sensitivity ~61–75%, specificity ~86–90%) (pubmed.ncbi.nlm.nih.gov).
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🕐 Lactate & Length of Stay (LOS)
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Direct data on LOS in paediatric oncology ICU is scarce.
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In broader PICU populations, elevated admission lactate correlates with:
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Longer ICU stay,
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More prolonged mechanical ventilation,
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Higher need for vasopressors (journals.lww.com, pubmed.ncbi.nlm.nih.gov).
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However, among infants with only lower respiratory infections, admission lactate didn’t predict overall hospital stay—suggesting illness type matters .
🧩 Likely in Critically Ill Paediatric Oncology Patients
It’s reasonable to infer that:
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Higher admission lactate reliably signals greater organ dysfunction or metabolic stress.
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It likely predicts longer ICU stays, as seen in more general PICU cohorts.
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The magnitude of impact may differ based on:
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Cancer type,
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Treatment protocols,
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Complicating factors like sepsis or organ failure.
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🔁 Lactate Dynamics Over Time Matter
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Many studies show lactate clearance (e.g., change in first 6–24 h) is a stronger mortality and outcome indicator than a single value (pubmed.ncbi.nlm.nih.gov).
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Persistent lactate elevation beyond 24 h is strongly linked to mortality.
✅ In Summary
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A higher serum lactate at ICU admission in critically ill children—including oncology patients—is a robust marker of severity.
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It strongly predicts mortality and likely indicates longer ICU stays, particularly if levels remain elevated.
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Early serial measurements and tracking lactate clearance provide added value for trend interpretation.
🔍 Next steps:
It would be very informative to locate the exact study you're referencing. If you can share authors, year, or a DOI, I can dig deeper. Or, I can help summarize findings from a related paediatric oncology ICU cohort—just let me know!
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