Observational Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Jan 9, 2023; 12(1): 1-9
Published online Jan 9, 2023. doi: 10.5492/wjccm.v12.i1.1
Role of cerebrospinal fluid lactate in diagnosing meningitis in critically ill patients
Devraj Yadav, Omender Singh, Deven Juneja, Amit Goel, Sahil Kataria, Anisha Beniwal
Devraj Yadav, Omender Singh, Deven Juneja, Amit Goel, Sahil Kataria, Anisha Beniwal, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, New Delhi 110017, India
Author contributions: Yadav D, Singh O, and Juneja D designed the study. Yadav D, Kataria S, and Beniwal A collected the data, and analyzed the results. Yadav D, and Juneja D performed majority of the writing, and prepared the tables; Singh O, Goel A, Kataria S and Beniwal A provided the inputs in writing the paper and reviewed the manuscript.
Institutional review board statement: The study was reviewed and approved by the Max Super Speciality Hospital, Saket, New Delhi, Institutional Review Board via letter no. TS/MSSH/MHIL/SKT-1/MHEC/CC/20-17.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Deven Juneja, DNB, FCCP, MBBS, Director, Institute of Critical Care Medicine, Max Super Speciality Hospital, Saket, 1, Press Enclave Road, New Delhi 110017, India. devenjuneja@gmail.com
Received: November 7, 2022
Peer-review started: November 7, 2022
First decision: November 25, 2022
Revised: November 30, 2022
Accepted: December 23, 2022
Article in press: December 23, 2022
Published online: January 9, 2023
Processing time: 56 Days and 18.5 Hours
Core Tip

Core Tip: We conducted a prospective, observational cohort study to assess the efficacy of cerebrospinal fluid (CSF) lactate in diagnosing meningitis in critically ill patients. 71 patients were included and 23 were diagnosed with meningitis. There was a significant correlation of CSF lactate levels with CSF cultures and meningo-encephalitis panel. CSF lactate (> 2.72 mmol/L) showed good accuracy in diagnosing meningitis with an area under the curve (AUC) of 0.81, sensitivity 82.6%, and specificity 72.9%. These values were comparable to those of CSF total leucocyte count (TLC) and protein. Twelve patients with bacterial meningitis had significantly higher CSF lactate (8.9 ± 4.7 mmol/L) than those with non-bacterial meningitis (4.2 ± 3.8 mmol/L), P = 0.006. To conclude, CSF lactate may be used to aid in our diagnosis of meningitis in critically ill patients.