Monitoring the effectiveness of hypothermia in perinatal asphyxia infants by urinary S100B levels

2019 ◽  
Vol 57 (7) ◽  
pp. 1017-1025
Author(s):  
Iliana Bersani ◽  
Fabrizio Ferrari ◽  
Licia Lugli ◽  
Giorgio Ivani ◽  
Alessandra Conio ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Time Window ◽  
Perinatal Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Longitudinal Assessment ◽  
Retrospective Case ◽  
Mortality And Morbidity ◽  
Hypothermia Treatment ◽  
Normal Ranges ◽  
Ischemic Encephalopathy

Abstract Background Perinatal asphyxia is a major cause of mortality and morbidity in neonates: The aim of the present study was to investigate, by means of longitudinal assessment of urinary S100B, the effectiveness of hypothermia, in infants complicated by perinatal asphyxia and hypoxic-ischemic encephalopathy. Methods We performed a retrospective case-control study in 108 asphyxiated infants, admitted to nine tertiary departments for neonatal intensive care from January 2004 to July 2017, of whom 54 underwent hypothermia treatment and 54 did not. The concentrations of S100B protein in urine were measured using an immunoluminometric assay at first urination and 4, 8, 12, 16, 20, 24, 48, 72, 96, 108 and 120 h after birth. The results were correlated with the achievement of S100B levels within normal ranges at 72 h from hypothermia treatment. Routine laboratory parameters, longitudinal cerebral function monitoring, cerebral ultrasound and neurologic patterns were assessed according to standard protocols. Results Higher S100B concentrations were found in hypothermia-treated infants in both moderate (up to 12 h) and severe (up to 24 h) hypoxic-ischemic encephalopathy. S100B levels returned to normal ranges starting from 20 h of hypothermia treatment in moderate and from 36 h in severe hypoxic-ischemic encephalopathy. Conclusions The present results offer additional support to the usefulness of longitudinal neuro-biomarkers monitoring in asphyxiated infants treated by hypothermia. The pattern of S100B concentrations during hypothermia supports the need for further investigations aimed at reconsidering the time-window for patient recruitment and treatment, and the optimal duration of the cooling and rewarming phases of the hypothermia procedure.

scholarly journals Prognostic Risk Factors for Severe Outcome in the Acute Phase of Neonatal Hypoxic-Ischemic Encephalopathy: A Prospective Cohort Study

Children ◽  
2021 ◽  
Vol 8 (12) ◽  
pp. 1103
Author(s):  
Agnese Suppiej ◽  
Giovanna Vitaliti ◽  
Giacomo Talenti ◽  
Vittoria Cuteri ◽  
Daniele Trevisanuto ◽  
...  
Keyword(s):  
Apgar Score ◽  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Univariate Analysis ◽  
Mode Of Delivery ◽  
Epileptic Seizures ◽  
Final Analysis ◽  
Hypoxic Ischemic Encephalopathy ◽  
Risk Of Death ◽  
Ischemic Encephalopathy

In the first days after birth, a major focus of research is to identify infants with hypoxic-ischemic encephalopathy at higher risk of death or severe neurological impairment, despite therapeutic hypothermia (TH). This is especially crucial to consider redirection of care, according to neonatal outcome severity. We aimed to seek associations between some neonatal routine parameters, usually recorded in Neonatal Intensive Care Units, and the development of severe outcomes. All consecutive patients prospectively recruited for TH for perinatal asphyxia, born between February 2009 and July 2016, were eligible for this study. Severe outcome was defined as death or major neurological sequelae at one year of age. Among all eligible neonates, the final analysis included 83 patients. Severe outcome was significantly associated with pH and base excess measured in the first hour of life, mode of delivery, Apgar score, Sarnat and Sarnat score, electroencephalogram-confirmed neonatal epileptic seizures, and antiepileptic therapy. Studying univariate analysis by raw relative risk (RR) and 95% confidence intervals (CI), severe outcome was significantly associated with pH (p = 0.011), Apgar score (p = 0.003), Sarnat score (p < 0.001), and Caesarian section (p = 0.015). Conclusions. In addition to clinical examination, we suggest a clinical-electroencephalographic protocol useful to identify neonates at high neurological risk, available before rewarming from TH.

scholarly journals Correlation of serum creatinine kinase muscle-brain fraction and lactate dehydrogenase with severity of hypoxic ischemic encephalopathy in perinatal asphyxia in term neonates

2018 ◽  
Vol 5 (2) ◽  
pp. 405
Author(s):  
Masaraddi Sanjay K. ◽  
Ahamed Roshan P. M. ◽  
Nedunchezhian P. ◽  
Sulekha C.
Keyword(s):  
Lactate Dehydrogenase ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Term Neonate ◽  
Creatinine Kinase ◽  
Hypoxic Ischemic Encephalopathy ◽  
Case Group ◽  
Term Neonates ◽  
Mortality And Morbidity ◽  
Ischemic Encephalopathy

Background: Birth asphyxia in neonates significantly contributes to their mortality and morbidity, as it leads to hypoxic ischemic encephalopathy (HIE) and multi organ dysfunction. The present study was conducted with an objective to ascertain whether serum levels of creatinine kinase muscle-brain fraction (CK-MB) and lactate dehydrogenase (LDH) can distinguish an asphyxiated from a non-asphyxiated term neonate and correlation of these enzymes cut-off levels with severity of HIE in asphyxiated term neonates.Methods: This prospective study was conducted at Sree Mookambika Institute of Medical Sciences, Kulasekharam, Kanyakumari from September 2012 to December 2013. The study included 50 cases (asphyxiated neonates) and 50 controls (non-asphyxiated neonates) after fulfilling the requirements of inclusion criteria. Their blood samples were collected at 8±2 hours and 72±2 hours of age for estimation of CK-MB and LDH respectively and sent for analysis. The values were compared between cases and controls by using descriptive statistics.Results: The mean CK-MB level at 8±2 hours and mean LDH level at 72±2 hours were significantly higher in cases compared to controls with p<0.001. Among the 50 neonates in case group, 19 (38%) had clinical evidence of HIE. Of them 3 (6%) had mild HIE, 12 (24%) had moderate HIE and 4 (8%) had severe HIE during the course in NICU. The correlation of Apgar scores of 0-3 and 4-6 at 1 minute and 5 minutes with the severity of HIE and the correlation of cut-off CK-MB level of 92.6 U/L and cut-off LDH level of 580 U/L with the severity of HIE were not significant (p>0.05).Conclusions: We conclude that estimating the levels CK-MB at 8 hours of life and LDH at 72 hours of life can help to distinguish an asphyxiated from a non-asphyxiated term neonate with reasonable degree of accuracy but the enzyme cut-off levels do not correlate with severity of HIE in asphyxiated term neonates. 

Liver laceration presented as intraabdominal bleeding in a newborn with hypoxic-ischemic encephalopathy

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Turkay Rzayev ◽  
Kivilcim Karadeniz Cerit ◽  
Nurdan Yildiz ◽  
Hulya Ozdemir ◽  
Asli Memisoglu ◽  
...  
Keyword(s):  
Neonatal Intensive Care ◽  
Perinatal Asphyxia ◽  
Multiorgan Failure ◽  
Hypoxic Ischemic Encephalopathy ◽  
Case Presentation ◽  
Second Stage Of Labor ◽  
Second Stage ◽  
Abdominal Bleeding ◽  
Ischemic Encephalopathy

Abstract Objectives Birth injuries usually occur with two different mechanisms: trauma due to mechanic stress during labor and hypoxic-ischemic injury. Sometimes these two mechanisms can occur at the same time with a complex clinical picture. Case presentation The baby girl was born at 372/7 weeks after a prolonged second stage of labor, weighing 3,725 g, and was admitted to the Neonatal Intensive Care Unit with the diagnosis of hypoxic-ischemic encephalopathy. During follow up she developed multiorgan failure and severe anemia. On the third postnatal day, abdominal bleeding was detected. Laceration in the liver capsule was found and appeared to be the source of bleeding. Conclusions Abdominal bleeding secondary to mechanical laceration of the liver is hard to diagnose and may coexist with perinatal asphyxia.

Perinatal Asphyxia with Hyperoxemia within the First Hour of Life Is Associated with Moderate to Severe Hypoxic-Ischemic Encephalopathy

2013 ◽  
Vol 163 (4) ◽  
pp. 949-954 ◽  
Author(s):  
Vishal S. Kapadia ◽  
Lina F. Chalak ◽  
Tara L. DuPont ◽  
Nancy K. Rollins ◽  
Luc P. Brion ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Hypoxic Ischemic Encephalopathy ◽  
Ischemic Encephalopathy

scholarly journals The Effect of the Excretion of Calcium, Magnesium, and Phosphate on the Serum Levels of These Substances in Newborns Who Therapeutic Hypothermia for Hypoxic Ischemic Encephalopathy

2021 ◽  
Author(s):  
Osman Baştuğ ◽  
Bahadır İnan ◽  
Ahmet Özdemir ◽  
Binnaz Çelik ◽  
Funda Baştuğ ◽  
...  
Keyword(s):  
Urinary Excretion ◽  
Therapeutic Hypothermia ◽  
Perinatal Asphyxia ◽  
Serum Levels ◽  
Hypoxic Ischemic Encephalopathy ◽  
Control Group ◽  
P Value ◽  
Electrolyte Disturbances ◽  
Significant Difference ◽  
Ischemic Encephalopathy

Abstract Background: Hypocalcemia, hypomagnesemia, and hyperphosphatemia are common electrolyte disturbances in perinatal asphyxia(PA). Different reasons have been proposed for these electrolyte disturbances. This study investigated the effect of the urinary excretion of calcium(Ca), magnesium(Mg), and phosphorus(P) on the serum levels of these substances in babies who were treated using therapeutic hypothermia for hypoxic ischemic encephalopathy(HİE) caused by PA. This study sheds light on the pathophysiology that may cause changes in the serum values of these electrolytes.Method: This study included 21 healthy newborns(control group) and 38 patients(HİE group) who had undergone therapeutic hypothermia due to HİE. Only infants with a gestational age of 36 weeks and above and a birth weight of 2000 g and above were evaluated. The urine and serum Ca, Mg, P, and creatinine levels of all infants were evaluated at 24, 48, and 72 hours.Results: The lower serum Ca value and the higher serum P value of the HİE group were found to be statistically significant compared to the control group. There was no significant difference in serum Mg values between the groups. However, hypomagnesemia was detected in five patients from the HİE group. The urine excretions of these substances, which were checked at different times, were found to be significantly higher in the HİE group compared to the control group.Conclusion: This study determined that the urinary excretion of Ca, Mg, and P has an effect on the serum Ca, Mg, and P levels of infants with HİE.

scholarly journals Quantitative EEG in babies at risk for hypoxic ischemic encephalopathy after perinatal asphyxia

2009 ◽  
Vol 30 (2) ◽  
pp. 122-126 ◽  
Author(s):  
M Hathi ◽  
D L Sherman ◽  
T Inder ◽  
N S Rothman ◽  
M Natarajan ◽  
...  
Keyword(s):  
At Risk ◽  
Perinatal Asphyxia ◽  
Quantitative Eeg ◽  
Hypoxic Ischemic Encephalopathy ◽  
Ischemic Encephalopathy

scholarly journals Exploring Perinatal Asphyxia by Metabolomics

Metabolites ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. 141 ◽  
Author(s):  
Emanuela Locci ◽  
Giovanni Bazzano ◽  
Roberto Demontis ◽  
Alberto Chighine ◽  
Vassilios Fanos ◽  
...  
Keyword(s):  
Perinatal Asphyxia ◽  
Relevant Literature ◽  
Hypoxic Ischemic Encephalopathy ◽  
Health Concern ◽  
Resonance Spectroscopy ◽  
Industrialized Countries ◽  
Human Infants ◽  
Therapeutic Tools ◽  
Effective Use ◽  
Ischemic Encephalopathy

Brain damage related to perinatal asphyxia is the second cause of neuro-disability worldwide. Its incidence was estimated in 2010 as 8.5 cases per 1000 live births worldwide, with no further recent improvement even in more industrialized countries. If so, hypoxic-ischemic encephalopathy is still an issue of global health concern. It is thought that a consistent number of cases may be avoided, and its sequelae may be preventable by a prompt and efficient physical and therapeutic treatment. The lack of early, reliable, and specific biomarkers has up to now hampered a more effective use of hypothermia, which represents the only validated therapy for this condition. The urge to unravel the biological modifications underlying perinatal asphyxia and hypoxic-ischemic encephalopathy needs new diagnostic and therapeutic tools. Metabolomics for its own features is a powerful approach that may help for the identification of specific metabolic profiles related to the pathological mechanism and foreseeable outcome. The metabolomic profiles of animal and human infants exposed to perinatal asphyxia or developing hypoxic-ischemic encephalopathy have so far been investigated by means of 1H nuclear magnetic resonance spectroscopy and mass spectrometry coupled with gas or liquid chromatography, leading to the identification of promising metabolomic signatures. In this work, an extensive review of the relevant literature was performed.

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