The Role of Serum Lactate as a Prognostic Biomarker in Major Burn Patients: A Prospective Study

Abstract

Background: Severe burn results in a devastating andunique derangement called burn shock. Fluid resuscitation isthe foundation of immediate burn care, and the primary goalof resuscitation is to restore and preserve tissue perfusion. Historically,resuscitation has been guided by a combination ofbasic laboratory values, invasive maneuvers, and clinical data,but the optimal guide to the end point of resuscitation remainscontroversial.Objective: The aim of this study is: To investigate thediagnostic and prognostic validity of serum lactate in majorburn patients and to determine the utility of an initial and serialserum lactate measurement during the first 36 hours foridentifying substantial risk of death and adequacy of fluid resuscitation.Patients and Methods: 40 individuals who had significantburns (greater than 20% of TBSA). Both operated and non-operatedpatients are included. Twenty were female and twentywere male of the forty cases. The research covered all adultburn patients hospitalized during the first twenty-four hoursfollowing their injury. Individuals who were released or died48 hours after admission, or who were hospitalized after 24hours following a thermal injury, were not included.Results: As a prognostic tool, serial blood lactate measurementsperformed better than solitary measurements. 24 hoursafter admission, lactate levels that were reduced or returned tonormal were linked to a better chance of survival. Since serialblood lactate measurements predict death in patients withsignificant burns, this study validates the predictive utility ofserum lactate for mortality in these patients.Conclusion: Our study demonstrated that lactate level inmajor burn patients is a promising prognostic biomarker, thatcould facilitate ideal management and initiate proper antimicrobialtherapy and good prognostic value as an early predictorof mortality.