Journal
ACTA PAEDIATRICA
Volume 101, Issue 10, Pages 1038-1044Publisher
WILEY
DOI: 10.1111/j.1651-2227.2012.02778.x
Keywords
Hypothermia; Lactate dehydrogenase; Perinatal asphyxia
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Funding
- Bristol University Hospitals.
- University of Bristol, UK charity SPARKS (Sport Aiding Medical Research for Kids)
- University of Bristol, UK charity AMR (Action medical Research)
- Action Medical Research [1840] Funding Source: researchfish
- Sparks Charity [05BTL01] Funding Source: researchfish
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Aims: We investigated whether plasma lactate dehydrogenase (LDH) predicts outcome in hypothermia (HT)-treated term infants with moderate/severe hypoxic-ischaemic encephalopathy (HIE) and additionally whether LDH differs between infants with evidence for acute and nonacute perinatal insults and postnatal collapse (PNC). Methods: Data from HT-treated infants with HIE (n = 39) were analysed retrospectively. Adverse outcome was defined as a Mental and/or Psychomotor Developmental Index (Bayley Scales of Infant Development II), at 18 months <70. The likely timing of insult onset was assessed in infants with an LDH sample obtained within 6 h of birth or PNC (n = 20). Results: LDH differed between the favourable/adverse outcome groups at the end of HT treatment (median (IQR) 1540 (14001950)U/L vs. 3555 (30038705)U/L, (p < 0.01)). All infants (n = 22) with LDH <2085U/L had a favourable outcome while 6 of 11 infants with LDH = 2085U/L had an adverse outcome. LDH in those who died (n = 4) was higher than the favourable outcome group (5090 (291512222)U/L, (p < 0.01)) but sampled earlier. Early LDH differed significantly (p < 0.01) between infants with evidence for acute or nonacute insults or PNC. Conclusion: These results offer a biomarker, with high negative predictive value in the assessment of outcome in HT-treated term infants, needing prospective validation.
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