Lactate dehydrogenase in hypothermia-treated newborn infants with hypoxic-ischaemic encephalopathy

Marianne Thoresen, Xun Liu, Sally Jary, Emma L Scull-Brown, Hemmen Sabir, Janet Stone, Frances Cowan, Mathias Karlsson

Research output: Contribution to journalArticle (Academic Journal)peer-review

23 Citations (Scopus)

Abstract

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 (1400-1950)U/L vs. 3555 (3003-8705)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 (2915-12222)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.

Translated title of the contributionLactate dehydrogenase: a valid outcome- predictor in hypothermia treated newborn infants with hypoxic ischemic encephalopathy
Original languageEnglish
Pages (from-to)1038-1044
Number of pages7
JournalActa Paediatrica
Volume101
Issue number10
Early online date27 Jul 2012
DOIs
Publication statusPublished - Oct 2012

Bibliographical note

© 2012 The Author(s)/Acta Paediatrica © 2012 Foundation Acta Paediatrica.

Keywords

  • Severity of Illness Index
  • Developmental Disabilities
  • Asphyxia Neonatorum
  • ROC Curve
  • Chi-Square Distribution
  • Humans
  • Retrospective Studies
  • Prognosis
  • Infant, Newborn
  • England
  • Outcome Assessment (Health Care)
  • Infant, Premature
  • L-Lactate Dehydrogenase
  • Hypoxia-Ischemia, Brain
  • Time Factors
  • Hypothermia, Induced
  • Biological Markers
  • Female
  • Male

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