Study of Myocardial Dysfunction in Perinatal Asphyxia Field

2018 ◽  
Vol 2 (S1) ◽  
pp. e000127
Author(s):  
Kushali Tanna ◽  
K M Mehariya ◽  
Suchita Munsi ◽  
Charul Pujani
Keyword(s):  
Troponin I ◽  
Heart Diseases ◽  
Perinatal Asphyxia ◽  
Myocardial Dysfunction ◽  
Birth Asphyxia ◽  
Serum Levels ◽  
Spontaneous Respiration ◽  
Term Neonates ◽  
Myocardial Involvement ◽  
Ischemic Encephalopathy

Aims and Objectives: To study an incidence of myocardial dysfunction in neonates admitted with perinatal asphyxia, to find out its correlation with severity of birth asphyxia and its outcome. Methods: This prospective study was conducted among 40 term neonates admitted in NICU of Civil Hospital Ahmedabad who had suffered with perinatal asphyxia (defined by WHO ), resuscitated as per NRP guidelines-2015 including both intramural and extramural admissions and who developed to hypoxic ischemic encephalopathy as defined by Levene staging. Neonates with congenital heart diseases, major central nervous system malformations and neonatal sepsis were excluded. Myocardial involvement was assessed by clinical evaluation, ECG, Creatinine Kinase Total (25-200IU/L), CK-MB (0-25IU/L) and Troponin I (0-0.03ug/L) measurements. Results: Among 40 cases, 10(25%) neonates had moderate birth asphyxia while 30(75%) had severe birth asphyxia. Respiratory distress was observed in 34(77.5%), poor spontaneous respiration 4(10%),shock in 14(35%),CCF 19(47.5%) while ECG was abnormal in 30(76.7%). Serum levels of CPK Total, CPK- MB and Troponin I were raised in 34(85%), 32(80%) and 28 (70%) neonates, respectively.  Conclusion: There was a direct correlation between ECG changes and enzymatic levels which showed increasing abnormalities with increasing with severity of HIE.  

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. 

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 Study of cord blood nucleated RBC’s as a marker for fetal asphyxia

2017 ◽  
Vol 6 (2) ◽  
pp. 658
Author(s):  
Suvarna Jyothi Ganta ◽  
Sunanda R. Kulkarni
Keyword(s):  
Cord Blood ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Control Group ◽  
Apgar Scores ◽  
Hypoxic Episode ◽  
The Mean ◽  
Ischemic Encephalopathy ◽  
Control Study

Background: Perinatal asphyxia is a serious problem globally and is a common cause of neonatal mortality and long term morbidity. Various Parameters are being used as predictors for birth asphyxia but the correlation between clinical presentation and the biochemical results has been unsatisfactory. NRBC count of the cord blood is reported in literature as a possible marker of perinatal asphyxia. In-utero hypoxic episode may induce a haemopoetic response of exaggerated erythropoiesis leading to the presence of nucleated RBC's in fetal circulation. The aim of this study was to investigate whether NRBC count of the cord blood can be a useful parameter to determine perinatal asphyxia.Methods: This prospective case control study was conducted in Chinmaya Mission hospital, Bangalore, India between July 2015 to June 2016.we have studied the NRBC counts from the cord blood of 50 neonates with perinatal asphyxia and 50 healthy neonates, thus comparing the results.Results: The mean NRBC /100 WBC for cases with birth asphyxia was 11.6 and that of the control group was 5.6. NRBC count was found to be significantly higher in neonates with low Apgar scores. There was correlation between the Apgar scores at 1st and at 5 minutes, the degree of Hypoxic Ischemic Encephalopathy and the NRBC counts.Conclusions: Therefore NRBC counts of the cord blood can be used as an effective tool to confirm perinatal asphyxia. It is a simple, quick, accurate and clinically effective test to diagnose and initiate treatment to prevent long term sequel of perinatal asphyxia.

scholarly journals Abnormal biochemical parameters among term neonates with perinatal asphyxia and their non-asphyxiated controls in Osogbo

2021 ◽  
Vol 9 (3) ◽  
pp. 308-319
Author(s):  
O.V. Kayode ◽  
O.J. Adebami ◽  
O.A. Oyedeji ◽  
S.O. Oninla ◽  
S.B.A. Oseni ◽  
...  
Keyword(s):  
Biochemical Parameters ◽  
Case Control Study ◽  
Perinatal Asphyxia ◽  
Serum Levels ◽  
Case Control ◽  
Serum Electrolytes ◽  
Term Neonates ◽  
Standard Methods ◽  
Control Study ◽  
Prospective Case Control Study

Objective: This study aimed to determine the prevalence of abnormal biochemical parameters among neonates with perinatal asphyxia in comparison to their non-asphyxiated controls.Methodology: This is a prospective case - control study involving 54 asphyxiated term neonates and 54 non-asphyxiated term babies at LAUTECH teaching hospital, Osogbo. Serum levels of Sodium, Bicarbonate, Chloride, Calcium and Potassium were determined daily for 72 hours in both groups using standard methods. The results were compared.Results: The overall prevalence of abnormal biochemical parameters namely hyponatraemia, hypocalcaemia, metabolic acidosis, hypochloraemia and hypokalaemia among the asphyxiated versus non-asphyxiated babies in the first 72 hours of life were 30.9% vs 19.8% (p < 0.020); 28.4% vs 4.9% (p < 0.000); 30.9% vs 3.1% (p < 0.0001); 27.2% vs 25.9% (p < 0.200) and 24.7% vs 3.1% (p < 0.070) respectively.Conclusion: Babies with hypoxic ischaemic encephalopathy stage III significantly showed the worst biochemical parameters; early estimation of serum electrolytes in neonates with perinatal asphyxia may be appropriate for timely intervention.  

scholarly journals Correlation of Cord Lactate with Cord pH as a Morbidity Predictor in Term Neonates Delivered with Non-Reassuring Fetal Heart Status

2020 ◽  
Vol 8 (3) ◽  
pp. 17-22
Author(s):  
Aluru Ananya ◽  
Kanta Kumari PML ◽  
B Vijayalakshmi ◽  
R Chandrasekhar ◽  
Naga Saritha Kolli
Keyword(s):  
Fetal Heart ◽  
Perinatal Asphyxia ◽  
Multiple Logistic Regression Analysis ◽  
Colorimetric Method ◽  
Area Under The Curve ◽  
Birth Asphyxia ◽  
Roc Curve Analysis ◽  
Cross Sectional ◽  
Term Neonates ◽  
Significant Difference

Background: Perinatal asphyxia is accounting to 20% of neonatal mortalityin India. Cord lactate can be an alternative that is more readily available than cord pH and may help in early identification of birth asphyxia in resource limited settings. The aim of the current study is to correlate cord lactate levels with cord pH in term neonates with non-reassuring fetal heart status and thereby its use as a surrogate for cord    pH. Subjects & Methods: Study design: Cross-sectional study. Setting: Neonatology unit at NRI general hospital, Chinakakani from August 2018 to July 2019. Study participants: All singleton term neonates delivered by assisted vaginal delivery or emergency caesarean section due to non-reassuring fetal heart status. Umbilical cord blood gas and lactate was obtained. Lactate was analysed by colorimetric method. Results: A total of 74 neonates were included. An analysis of cord pH & lactate, using correlation coefficient showed statistically significant p-values. Cord lactate was found to be statistically significant predictor for admission to NICU, post resuscitation care, invasive/noninvasive ventilation, and therapeutic hypothermia on multiple logistic regression analysis. Cord Lactate was found to have an Area under the curve (AUC) of 0.88 with no significant difference to cord pH on ROC curve analysis. Conclusion: Cord Lactate can be used as an objective test in predicting the neonates requiring NICU admission for morbidities related to fetal hypoxia similar to that of cord pH in term neonates.

scholarly journals AB0567 CHARACTERIZATION OF PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHY AND MYOCARDIAL INVOLVEMENT: A MONO-CENTRIC EXPERIENCE.

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1580.3-1580
Author(s):  
R. De Lorenzo ◽  
S. Cavalli ◽  
F. Bonomi ◽  
S. Tronci ◽  
S. L. Calvisi ◽  
...  
Keyword(s):  
Skeletal Muscle ◽  
Troponin I ◽  
Troponin T ◽  
Myocardial Dysfunction ◽  
Muscle Disease ◽  
Idiopathic Inflammatory Myopathies ◽  
Inflammatory Myopathies ◽  
Muscle Testing ◽  
Immune Mediated ◽  
Myocardial Involvement

Background:Idiopathic inflammatory myopathies (IIM) are immune-mediated disorders of the skeletal muscle, with dermatomyositis (DM), polymyositis (PM), inclusion body myositis (IBM) and immune-mediated necrotizing myopathy (IMNM) representing major subtypes. Beyond skeletal muscle, other organs may be affected and myocardial involvement may lead to severe life-threatening complications. The exact prevalence of myocardial involvement among IIM patients and its impact on other disease characteristics remain unclear.Objectives:To investigate the prevalence of myocarditis in patients affected by IIM in and to determine whether the presence and extent of myocardial involvement identify a distinct disease phenotype.Methods:42 longitudinally followed IIM patients were routinely screened for myocardial involvement during a median [IQR] follow-up time of 4.2 [2-8.5] years. Patients with secondary causes of myocardial dysfunction were not included. Patients were considered to have myocarditis in case of:i) abnormal elevation of both circulating troponin T and troponin I,ii) signs of myocardial inflammation or necrosis/fibrosis at cardiac MRI, oriii) positive myocardial tissue histology. Demographic, clinical and serologic features of patients with myocarditis were compared to those with no sign of myocardial involvement. Moreover, we determined whether the extent of myocardial involvement based on troponin levels predicts skeletal muscle disease severity.Results:57.1% (24 of 42) of patients had myocarditis. The frequency of myocardial dysfunction was similar among patients with DM, PM, IBM or IMNM and was not related to autoantibody positivity. Myocarditis was not associated with sex or ethnicity. Patients with or without myocarditis were similar in terms of age at disease onset and extra-muscular manifestations including dysphonia, dysphagia, arthralgias or arthritis, Raynaud phenomenon or interstitial lung disease. Independent of the IIM subtype, the presence of perimysial macrophages at skeletal muscle biopsy seems to protect from myocarditis development (p=0.04). Patients with myocarditis had higher median [IQR] levels of aldolase (10.9 [7.8-15.8] vs. 5.6 [4.9-8.6], p=0.014) and creatine kinase (1785 [966-5852] vs. 685 [168-2255], p=0.04) compared to patients with no myocardial dysfunction. Among patients with myocarditis, levels of troponin I negatively correlated with manual muscle testing 8 (MMT8) score (r=-1, p=0.01), strength in biceps (r=-0.95, p=0.014) and wrist extensors (r=-0.95, p=0.014) at last visit. Troponin T and troponin I titers were similar among patients with different IIM subtypes. C-reactive protein (p<0.04) but not erythrocyte sedimentation rate was found to predict myocardial involvement.Conclusion:Our findings suggest that myocarditis is a frequent occurrence among patients with IIM and should be routinely ruled out. A more severe skeletal muscle disease is associated with an increased likelihood of myocarditis development, presumably due to higher systemic disease activity or inefficient disease control. The extent of myocardial damage faithfully reflects the severity of skeletal muscle dysfunction.References:[1]Dalakas MC. Inflammatory muscle diseases. N Engl J Med. 2015 Apr 30;372(18):1734-47. doi: 10.1056/NEJMra1402225.[2]Schwartz T, Diederichsen LP, Lundberg IE, et al. Cardiac involvement in adult and juvenile idiopathic inflammatory myopathies. RMD Open 2016;2:e000291. doi:10.1136/rmdopen-2016- 000291.Disclosure of Interests:None declared

Lactate Dehydrogenase, Aspartate Aminotransferase, and Alanine Aminotransferase Cord Serum Levels as Early Markers of Hypoxic–Ischemic Encephalopathy in Babies with Severe Perinatal Asphyxia

2018 ◽  
Vol 17 (03) ◽  
pp. 105-110
Author(s):  
Tolulope Ogundele ◽  
Saheed Babajide A. Oseni ◽  
Joshua A. Owa ◽  
Olorunfemi Ogundele
Keyword(s):  
Lactate Dehydrogenase ◽  
Apgar Score ◽  
Aspartate Aminotransferase ◽  
Alanine Aminotransferase ◽  
Perinatal Asphyxia ◽  
Serum Levels ◽  
Hypoxic Ischemic Encephalopathy ◽  
Apgar Scores ◽  
Cord Serum ◽  
Ischemic Encephalopathy

AbstractPerinatal asphyxia is a major cause of morbidity and mortality among newborn babies. Severe perinatal asphyxia can be associated with multiple organ dysfunctions resulting in the release of a variety of intracellular enzymes. A major concern is how to identify newborns in need of prompt and aggressive management to minimize the risk of early severe neurological sequelae such as hypoxic–ischemic encephalopathy. The present study was performed to determine the relationship between cord serum levels of lactate dehydrogenase, aspartate aminotransferase, alanine aminotransferase, and severity of perinatal asphyxia among Nigerian newborn babies. This was a prospective, comparative case–control study at the Obafemi Awolowo University Teaching Hospital, Ile-Ife. Cord blood was collected at delivery for serum levels of lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase. Each baby was evaluated for the severity of perinatal asphyxia at 1 minute of life using Apgar scores. Apgar score less than 7 at 1 minute was regarded as perinatal asphyxia. The Apgar scores were related to cord serum levels of the enzymes. The data were analyzed using Statistical Package for the Social Sciences for Windows, version 17.0. One hundred and forty babies, comprising 70 babies with and 70 babies without perinatal asphyxia were studied. Thirty-six (51.4%) of the neonates had severe perinatal asphyxia with Apgar score of 3 and below; 15 (41.7%) of the 36 had hypoxic–ischemic encephalopathy. The mean of values of each of the three enzymes was statistically significantly higher in babies with perinatal asphyxia compared with controls (p < 0.001 for each enzyme) and in babies with hypoxic–ischemic encephalopathy than in babies with severe perinatal asphyxia but without hypoxic–ischemic encephalopathy (p < 0.001). A very high proportion of babies with severe perinatal asphyxia developed hypoxic–ischemic encephalopathy. Based on the cord serum enzyme levels, almost all the babies who had hypoxic–ischemic encephalopathy would have been identified at delivery. Routine estimation of the cord serum levels of these enzymes among babies with severe perinatal may be used to identify babies who may develop acute serious neurological complications for anticipatory management.

scholarly journals Hepatic dysfunction in asphyxiated neonates: a prospective case: control study

2021 ◽  
Vol 8 (10) ◽  
pp. 1695
Author(s):  
Rajiv Prasad ◽  
Vibhuti Vaghela ◽  
Radhika Iyer ◽  
Siddharth Verma ◽  
Jigar Anadkat
Keyword(s):  
Liver Function ◽  
Case Control Study ◽  
Perinatal Asphyxia ◽  
Birth Asphyxia ◽  
Case Control ◽  
Full Term ◽  
Term Neonates ◽  
The Difference ◽  
Stage 1 ◽  
Control Study

Background: Birth asphyxia can lead to hypoxic damage to liver at cellular level which leads to release of liver enzymes in blood as well as altered liver function. This study aimed to study the alteration of hepatic function in birth asphyxia and correlate it with different stages of hypoxic ischemic encephalopathy (HIE).Method: A case control study was conducted at SMIMER Surat which involved 115 cases and 115 controls. Cases were full term neonates admitted in the NICU with an APGAR score of 6 or less at 1 minute of birth while controls were those neonates with an APGAR score of 7 or more. Blood samples were taken at 72 hours of life and liver function tests of the 2 groups were compared.Results: The difference in aspartate transferase (AST), alanine transferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP) levels of the cases and controls were statistically significant (p<0.05). However, difference in total protein and total bilirubin in between the 2 groups was statistically insignificant. The study also found that the difference in AST, ALT and LDH was statistically significant between HIE stage 1 and stage 2 (p<0.5), between HIE stage 1 and stage 3 (p<0.5) but insignificant between HIE stage 2 and stage 3 (p>0.5).Conclusions: The present study showed that the serum levels of hepatic enzymes were higher in full term neonates with perinatal asphyxia than full term neonates without perinatal asphyxia at the age of 72 hours. The enzyme levels showed an increasing trend with increasing severity of HIE.

Sign in / Sign up

Export Citation Format

Share Document