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Lactate – guide resuscitation — RACP Paediatrics MCQ

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ModerateEmergencyLactate – guide resuscitationRACP Paediatrics

A child presents in compensated septic shock (tachycardia, prolonged CRT, cool peripheries, maintaining BP). After blood cultures and IV antibiotics, what bedside blood test best guides the adequacy of fluid resuscitation?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Lactate

Serum lactate is the best bedside marker of tissue perfusion and adequacy of resuscitation in septic shock. An elevated lactate (>2 mmol/L) indicates tissue hypoperfusion. Serial lactate measurements guide the response to fluid resuscitation – a falling lactate indicates improving perfusion. Lactate clearance >10% per hour is a positive sign.

Reference: RCH Melbourne – 2023 – Sepsis CPG; Surviving Sepsis Campaign – 2020