Abstract 1166

Background: Arterial blood lactate has been widely used as an indicator of tissue hypoxia. Results of clinical studies suggest that plasma lactate values correlate with neurodevelopmental outcome in sick neonates with hypoxemia requiring extracorporeal membrane oxygenation. No clinical study has been conducted to evaluate value of blood lactate to predict neurodevelopmental outcome in very low birth weight babies.

Aims: To assess the value of arterial blood lactate, during the first 48 hours of life, as a predictor of developmental outcome in very low birth weight babies.

Method: Developmental assessments of 26 babies with birth weight of <1500 grams were done (Revised Gesell and Amatruda developmental schedule used) at a chronological age of 4 months. Serial arterial blood lactates and blood gases of these babies were measured during first 48 hours of life, using Chiron 865 blood gas machine. Developmental assessments were classified as normal, suspect and abnormal.

Results: Mean birth weight 962 (SD 307) grams. Mean gestational age 27 (SD 2.6) weeks. Mean chronological age at developmental assessment 30 weeks and mean adjusted age 17 weeks. The initial lactate ranged from 16 to 95 mg/dl with a mean of 43, and initial pH ranged from 7.2 to 7.45 with a mean of 7.31. By 48 hours the mean lactate had fallen to 38 (SD 31) and mean pH was 7.36 (SD 0.006). Multiple logistic regression analysis was done and no significant correlation between arterial blood lactate level, pH, or birth weight and early neurodevelopmental outcome was found.

Conclusion: Arterial blood lactate and pH during first 48 hours of life, do not predict early neurodevelopmental outcome in this small group of babies <1500 grams at birth. Further prospective clinical studies are required to evaluate the predictive value of elevated blood lactate in premature neonates <1500 grams.