scholarly journals Salivary Lactate Dehydrogenase in Relationship to the Severity of Hypoxic-Ischemic Encephalopathy among Newborn Infants

Scientifica ◽  
2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Hend Elmoursi ◽  
Mohamed Abdalla ◽  
Bader Eldin Mesbah ◽  
Abdelmoneim Khashana
Keyword(s):  
Lactate Dehydrogenase ◽  
Perinatal Asphyxia ◽  
Neurological Complication ◽  
Newborn Infants ◽  
Positive Association ◽  
Lactate Dehydrogenase Level ◽  
Hypoxic Ischemic Encephalopathy ◽  
Discriminative Ability ◽  
Frequent Seizure ◽  
Ischemic Encephalopathy

Introduction. Hypoxic-ischemic encephalopathy (HIE) is defined as a neurological complication that results from perinatal asphyxia. Previous studies had investigated various markers to early detect HIE; however, these markers appeared to have several drawbacks, especially in resource-limited settings. Aim. This study aimed at evaluating the predictive value of the salivary lactate dehydrogenase level as a potential predictor of hypoxic-ischemic encephalopathy for newborns. Materials and Methods. We included 30 neonates with HIE due to perinatal asphyxia and 30 healthy newborns that serve as controls, admitted at the intensive care unit for neonates and maternity ward at Ismailia area Clinics and Hospitals. We measured the LDH levels by using saliva samples that were collected for neonates maximum by 12 h after birth. Results. It was found that patients with HIE had a statistically significant higher salivary LDH level (1927 ± 390.3 IU/L) than patients without HIE (523.6 ± 142.8 IU/L) ( p < 0.001 ). Moreover, salivary LDH showed a good discriminative ability where the AUC was 0.966 regarding salivary LDH (95% CI: 0.917–1.0) ( p < 0.001 ). The best cutoff value was 1420 IU/L or more which showed the best results in predicting the occurrence of HIE with 98.3% and 97.6% sensitivity and specificity, respectively. Conclusion. Salivary LDH can be considered as a useful noninvasive laboratory marker that can accurately predict HIE incidence among neonates with asphyxia within 12 hours from birth. The cases in the HIE group were assigned into three stages according to the Sarnat and Sarnat staging system: stage I: mild (irritable, normal, or hypertonia and poor feeding); stage II: moderate (lethargy, hypotonia, and frequent seizure); stage III: severe (coma, flaccid, absent reflexes, and frequent seizure). There is a positive association between LDH levels and the severity of HIE.

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 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 Monitoring of neurological parameters in newborns with hypoxic-ischemic encephalopathy

2006 ◽  
Vol 59 (11-12) ◽  
pp. 531-538 ◽  
Author(s):  
Jasmina Djindjic ◽  
Slobodan Obradovic
Keyword(s):  
Gestational Age ◽  
Perinatal Asphyxia ◽  
Newborn Infants ◽  
Neurological Status ◽  
Neurological Complications ◽  
Hypoxic Ischemic Encephalopathy ◽  
Control Group ◽  
Floppy Infant ◽  
Pregnancy And Delivery ◽  
Ischemic Encephalopathy

Asphyxia i a condition caused by lack of oxygen in tissues and organs. The basic pathogenic mechanisms of asphyxia are: 1)hypoxemia, 2) ischemia. The effects of perinatal asphyxia on the brain of a neonatal baby are critical in development of hypoxic-ischemic encephalopathy. The diagnosis of hypoxic-ischemic encephalopathy is based on clinical data including course of pregnancy and delivery (Apgar score) and especially on the neurological status of the newborn (consciousness, tonus, convulsions, reflexes, vegetative functions, etc.) and it can be confirmed by biochemical analysis and neurological examinations. The aim of this paper is to determine the importance of prenatal and perinatal risk factors for hypoxic-ischemic encephalopathy, as well as their effects on the development of neurological complications and further neurological problems. The research included 148 newborn infants born in the period from January 1, 1996 to January 1, 1999, with gestational age of 27 to 42 weeks, with hypoxic ischemic lesions of the central nervosus system. The control group included 58 children of the same age and the same gestation, with generalized hypotonia ("floppy infant") but without any signs of hypoxic ischemic lesions of the central nervous system. In the group of examined newborn infants with hypoxic ischemic lesions, from 149 children 1 (0.67%) died, 87 (53.89%) had normal findings, whereas the handicap was established in 61 (40.94%). Perinatal asphyxia affects the fetus and newborn infants not by individual factors, but with at least three or four associated factors. The disorders caused by asphyxia are in inverse proportion to the duration and intensity of hypoxic insults and the gestational age of the newborn. .

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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