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Plasma Lactate Value as A Predictor Outcome in a Retrospective Study at Burn Unit in Cipto Mangunkusumo Hospital.

Latar belakang. Kadar laktat dalam plasma darah merupakan indicator adanya hipoksia seluler. Sementara pada pasien luka bakar proses inflamasi tidak hanya mempengaruhi bagian tubuh yang terkena luka bakar tetapi mengubah respon sistemik tubuh. Pasien dengan luka bakar derajat sedang akan memiliki kadar laktat yang melebihi kadar noermal, pengukuran kadar laktat yang berulang akan embantu dalam menilai respon terhadap terapi yang diberikan. Penelitian ini dilakukan untuk mengukur kadar lakat di masa awal cedera dan hubungannya dengan komplikasi sepsis dan angka mortaitas. Metodologi. Studi dilakukan secara retrospektif di Unit Luka Bakar Ciptomangunkusumo. Pasien dengan luka bakar derajat sedang akibat api atau air panas yang datang dalam rentang waktu 24 jam pertama dari bulan jauari 2012 hingga januari 2013 dimasukkan dalam studi ini. Kriteria inklusi adalah pasien dilakukan pemeriksaan lakatat saat 24 jam pertama dan setidaknya 2 kali selama rawat inap. Nilai laktat normal didefinisikan sebagai 1 ± 0.5 mmol/l. Hasil. Dalam 12 bulan studi ini terdapat 20 pasien yang masuk dalam kriteria inklusi. Perbandingan antara pria dan wanita adalah 16 :4. Usia rata-rata pasien adalah 30.55 tahun. Rerata luas luka bakar adalah 25.38 persen. Dalam 24 jam pertama kadar laktat meningkat dalam 75% pasien, dan pasien-pasien tersebut memiliki angka morbiditas sepsis yang lebih tinggi. Kesimpulan. Lactate value is a good predictor outcome for sepsis and mortality in burn patients.
Kata Kunci.Lactate, biomarker, sepsis, length of stay


Background: Lactate is a marker for cellular hypoxia. In burn patients the inflammation process not only affect the local wound but also affects the systemic response.,thus the increased value of lactate. Patients with moderate burn can have a higher level of lactate than normal value. Serial lactate measures can also help assess response to therapy that has been given. This study was made to assess whether the early plasma lactate (PL) level is a useful biomarker to predict septic complications and outcome in burn patients.
Material and methods. The study is done retrospectively in a burn center in ciptomangunkusumo hospital. Moderate burn patients due to thermal injury admitted within 24 hours post burn injury, from january 2012 to january 2013, were included. The inclusion criteria is the plasma lactate was measured early in the first 24 hours and controlled more than twice during the patients stay in the hospital. The normal lactate value was defined as 1 ± 0.5 mmol/l. Results. During the 12–month period of study, 20 patients were enrolled. Seixteen of them were male and four were female. The mean age was 30.55 years old. The average burn surface area was 25.38 percent. During the first 24 hour in burn patients the plasma lactate value more than normal was 75 percent. In those patients the results of sepsis and mortality rate is higher. Conclusion. Lactate value is a good predictor outcome for sepsis and mortality in burn patients.
Keywords.Lactate, biomarker, sepsis, length of stay