Urinary lactate to creatinine ratio in neonates with perinatal asphyxia and its correlation with severity of hypoxic 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.

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

Journal of Perinatology ◽

10.1038/jp.2009.130 ◽

2009 ◽

Vol 30 (2) ◽

pp. 122-126 ◽

Cited By ~ 4

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

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Association between Urinary Lactate to Creatinine Ratio and Neurodevelopmental Outcome in Term Infants with Hypoxic-Ischemic Encephalopathy

The Journal of Pediatrics ◽

10.1016/j.jpeds.2008.03.041 ◽

2008 ◽

Vol 153 (3) ◽

pp. 375-378.e2 ◽

Cited By ~ 16

Author(s):

William Oh ◽

Rebecca Perritt ◽

Seetha Shankaran ◽

Matthew Merritts ◽

Edward F. Donovan ◽

...

Keyword(s):

Neurodevelopmental Outcome ◽

Hypoxic Ischemic Encephalopathy ◽

Creatinine Ratio ◽

Term Infants ◽

Ischemic Encephalopathy

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Exploring Perinatal Asphyxia by Metabolomics

Metabolites ◽

10.3390/metabo10040141 ◽

2020 ◽

Vol 10 (4) ◽

pp. 141 ◽

Cited By ~ 2

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

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2018-1094 ◽

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.

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