scholarly journals Troponin I Levels in Neonatal Hypoxic–Ischemic Encephalopathy Are Related to Cardiopulmonary Comorbidity and Neurodevelopmental Outcomes

2021 ◽  
Vol 10 (17) ◽  
pp. 4010
Author(s):  
Da-Yang Chen ◽  
Inn-Chi Lee ◽  
Chin-Sheng Yu ◽  
Swee-Hee Wong ◽  
Ko-Huang Lue
Keyword(s):  
Odds Ratio ◽  
Functional Outcomes ◽  
Troponin I ◽  
Cardiac Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Short Term ◽  
Neurodevelopmental Outcomes ◽  
Prediction Rate ◽  
Ischemic Encephalopathy

Troponin I is a biomarker for cardiac injury in children. The role of troponin I in neonatal Hypoxic–Ischemic encephalopathy (HIE) may have valuable clinical implications. Troponin I levels were measured within 6 h of birth to determine their relationship to HIE stage, short-term cardiac functional outcomes, and neurodevelopmental outcomes at 1 year. Seventy-three patients were divided into two groups: mild HIE and moderate to severe HIE. Troponin I levels within 6 h of birth were obtained in 61 patients, and were significantly higher in patients with moderate to severe HIE than in patients with mild HIE (Mann–Whitney U test, U = 146, p = 0.001). A troponin I cut-off level of ≥60 pg/mL predicted moderate to severe HIE with a specificity of 81.1% and a negative prediction rate of 76.9%. A troponin I cut-off level of ≥180 pg/mL was significantly (χ2 (1, n = 61) = 33.1, p = 0.001, odds ratio 96.8) related with hypotension during first admission and significantly (χ2 (1, n = 61) = 5.3, p = 0.021, odds ratio 4.53) related with abnormal neurodevelopmental outcomes at 1 year. Early troponin I level may be a useful biomarker for predicting moderate to severe HIE, and initialization of hypothermia therapy.

Prognostic Value of Brain Magnetic Resonance Imaging in Neonatal Hypoxic-Ischemic Encephalopathy: A Meta-analysis

2017 ◽  
Vol 32 (13) ◽  
pp. 1065-1073 ◽  
Author(s):  
Iván Sánchez Fernández ◽  
J. Leon Morales-Quezada ◽  
Samuel Law ◽  
Paggie Kim
Keyword(s):  
Confidence Interval ◽  
Odds Ratio ◽  
Prognostic Value ◽  
Meta Analysis ◽  
Brain Mri ◽  
Brain Magnetic Resonance Imaging ◽  
Hypoxic Ischemic Encephalopathy ◽  
Resonance Imaging ◽  
Neonatal Brain ◽  
Ischemic Encephalopathy

Objective: To quantify the prognostic value of neonatal brain magnetic resonance imaging (MRI) in neonatal hypoxic-ischemic encephalopathy. Methods: Meta-analysis of studies with ≥35-week neonates with hypoxic-ischemic encephalopathy who underwent brain MRI within age 4 weeks and had neurodevelopmental follow-up for at least 12 months. Results: An abnormal neonatal brain MRI was more frequent among patients with unfavorable neurodevelopmental outcome: odds ratio = 18.2 (95% confidence interval: 9.4-34.9), P <.0001. The prognostic value of neonatal brain MRI in moderate hypoxic-ischemic encephalopathy had an odds ratio of 17.7 (95% confidence interval: 5.3-59.3) and in severe hypoxic-ischemic encephalopathy, the odds ratio was 125.0 (95% confidence interval: 2.0-7917.1). Therapeutic hypothermia did not change the prognostic value of neonatal brain MRI (odds ratio for hypothermia, 14.0 [95% confidence interval: 3.1-63.6], vs no hypothermia, 18.1 [95% confidence interval: 10.0-33.1], P = .7525). Conclusion: Neonatal brain MRI provides prognostic information on outcome beyond early infancy in hypoxic-ischemic encephalopathy and therapeutic hypothermia does not change its prognostic value.

scholarly journals Role of 20‐HETE in neuronal signaling and contribution to neonatal hypoxic‐ischemic encephalopathy

2012 ◽  
Vol 26 (S1) ◽  
Author(s):  
Raymond C Koehler ◽  
Zeng-Jin Yang ◽  
Erin L Carter ◽  
Kathleen K Kibler ◽  
Herman Kwansa ◽  
...  
Keyword(s):  
Hypoxic Ischemic Encephalopathy ◽  
Neuronal Signaling ◽  
Ischemic Encephalopathy

scholarly journals Troponin: the biomarker of choice for the detection of cardiac injury

2005 ◽  
pp. 1191-1202
Author(s):  
Luciano Babuin ◽  
Allan S. Jaffe
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Troponin I ◽  
Cardiac Injury ◽  
Transaminase Activity ◽  
Elevated Troponin ◽  
Critical Issues ◽  
European Society Of Cardiology

It has been known for 50 years that transaminase activity increases in patients with acute myocardial infarction. With the development of creatine kinase (CK), biomarkers of cardiac injury began to take a major role in the diagnosis and management of patients with acute cardiovascular disease. In 2000 the European Society of Cardiology and the American College of Cardiology recognized the pivotal role of biomarkers and made elevations in their levels the “cornerstone” of diagnosis of acute myocardial infarction. At that time, they also acknowledged that cardiac troponin I and T had supplanted CK-MB as the analytes of choice for diagnosis. In this review, we discuss the science underlying the use of troponin biomarkers, how to interpret troponin values properly and how to apply these measurements to patients who present with possible cardiovascular disease. Troponin is the biomarker of choice for the detection of cardiac injury. To use it properly, one must understand how sensitive the specific assay being used is for detecting cardiac injury, the fact that elevated troponin levels are highly specific for cardiac injury and some critical issues related to the basic science of the protein and its measurement. In this article, we review the biology of troponin, characteristics of assays that measure serum troponin levels and how to apply these measurements to patients who present with possible cardiovascular disease. We also discuss other clinical situations in which troponin levels may be elevated.

Clinical Profile and Short-Term Outcome of Neonatal Seizures in a Tertiary Care Hospital, Kuppam – A Retrospective Study

2021 ◽  
Vol 8 (27) ◽  
pp. 2381-2386
Author(s):  
Poojitha Kancherla ◽  
Harsha P.J. ◽  
Gowtham R. ◽  
Dowlath Anwar Basha ◽  
Chandran G.P ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Clinical Profile ◽  
Hypoxic Ischemic Encephalopathy ◽  
Care Hospital ◽  
Neonatal Seizures ◽  
Metabolic Disturbances ◽  
Short Term ◽  
Term Outcome ◽  
Short Term Outcome ◽  
Ischemic Encephalopathy

BACKGROUND Neonates presenting with seizures require long term stay in hospital and have higher chances of neuro-developmental delay later. Seizures in neonates are mostly subtle and difficult to diagnose. We wanted to study the clinical profile and short-term outcome on term and later pre-term neonates presenting with seizures. METHODS The study was a retrospective observational study done from November to December 2020 at PES Hospital, Kuppam. Retrospective data of neonatal seizures from May 2019 to April 2020 was considered for study. Details from the case records of neonates with seizures was collected. RESULTS Neonatal seizures (NS) were most common in females (53.8 %, 72/134). Subtle seizures were most common form of seizures in neonates which was seen in 64.2 % (86/134) babies followed by tonic seizures in 22.4 % (30/134). Neonatal seizures were most commonly seen in babies with hypoxic ischemic encephalopathy in 63.4 % (85/134) followed by metabolic disturbances in 15.6 % (21/134) and meningitis in 13.5 % (18/134). In babies with hypoxic ischemic encephalopathy, metabolic and meningitis subtle seizures were observed to be more common. Seizures were seen most commonly in first 72 hours of life (82.85 %, 111/134). Seizures in babies with hypoxic ischemic encephalopathy, metabolic causes most commonly occurred within first 24 hours of birth. Seizures in babies with meningitis most commonly occurred after 7 days of birth. Babies with neonatal seizures with sequelae was seen in 17.96 % (24/134) and 11.94 % babies died (16/134). CONCLUSIONS Subtle seizures were most common form and hypoxic ischemic encephalopathy was most common risk factor. Most neonatal seizures present within 72 hours of birth. Babies with meningitis presented with seizures most commonly after 72 hours of birth. KEYWORDS Hypoxic Ischemic Encephalopathy, Neonatal Seizures, Newborn, Aetiology, Outcome

scholarly journals Prognostic role of acute kidney injury on long-term outcome in infants with hypoxic-ischemic encephalopathy

2019 ◽  
Vol 35 (3) ◽  
pp. 477-483 ◽  
Author(s):  
Francesco Cavallin ◽  
Giulia Rubin ◽  
Enrico Vidal ◽  
Elisa Cainelli ◽  
Luca Bonadies ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Prognostic Role ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Ischemic Encephalopathy

scholarly journals Correlation Between White Matter Injury Identified by Neonatal Diffusion Tensor Imaging and Neurodevelopmental Outcomes Following Term Neonatal Asphyxia and Therapeutic Hypothermia: An Exploratory Pilot Study

2019 ◽  
Vol 34 (10) ◽  
pp. 556-566 ◽  
Author(s):  
Gwendolyn J. Gerner ◽  
Eric I. Newman ◽  
V. Joanna Burton ◽  
Brenton Roman ◽  
Elizabeth A. Cristofalo ◽  
...  
Keyword(s):  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Pilot Study ◽  
Therapeutic Hypothermia ◽  
Diffusion Tensor ◽  
White Matter Injury ◽  
Hypoxic Ischemic Encephalopathy ◽  
Group Differences ◽  
Neurodevelopmental Outcomes ◽  
Ischemic Encephalopathy

Aim: Hypoxic-ischemic encephalopathy is associated with damage to deep gray matter; however, white matter involvement has become recognized. This study explored differences between patients and clinical controls on diffusion tensor imaging, and relationships between diffusion tensor imaging and neurodevelopmental outcomes. Method: Diffusion tensor imaging was obtained for 31 neonates after hypoxic-ischemic encephalopathy treated with therapeutic hypothermia and 10 clinical controls. A subgroup of patients with hypoxic-ischemic encephalopathy (n = 14) had neurodevelopmental outcomes correlated with diffusion tensor imaging scalars. Results: Group differences in diffusion tensor imaging scalars were observed in the putamen, anterior and posterior centrum semiovale, and the splenium of the corpus callosum. Differences in these regions of interest were correlated with neurodevelopmental outcomes between ages 20 and 32 months. Conclusion: Therapeutic hypothermia may not be a complete intervention for hypoxic-ischemic encephalopathy, as neonatal white matter changes may continue to be evident, but further research is warranted. Patterns of white matter change on neonatal diffusion tensor imaging correlated with neurodevelopmental outcomes in this exploratory pilot study.

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