Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study

Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the most common cause of mortality and neurological disability in infancy after perinatal asphyxia. Reliable biomarkers to predict neurological outcomes of neonates after perinatal asphyxia are still not accessible in clinical practice. M...

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Autores principales:	Yi-Fang Tu, Po-Ming Wu, Wen-Hao Yu, Chung-I Li, Cheng-Lin Wu, Lin Kang, Yung-Chieh Lin, Hsin-I Shih, Chao-Ching Huang
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	perinatal asphyxia lactate neurological outcomes neonatal hypoxic-ischemic encephalopathy Science Q
Acceso en línea:	https://doaj.org/article/735ef3bff9ef4d69a22fdf8066cd1220
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spelling	oai:doaj.org-article:735ef3bff9ef4d69a22fdf8066cd12202021-11-25T18:11:04ZLactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study10.3390/life111111932075-1729https://doaj.org/article/735ef3bff9ef4d69a22fdf8066cd12202021-11-01T00:00:00Zhttps://www.mdpi.com/2075-1729/11/11/1193https://doaj.org/toc/2075-1729Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the most common cause of mortality and neurological disability in infancy after perinatal asphyxia. Reliable biomarkers to predict neurological outcomes of neonates after perinatal asphyxia are still not accessible in clinical practice. Methods: A prospective cohort study enrolled neonates with perinatal asphyxia. Biochemical blood tests and cerebral Doppler ultrasound were measured within 6 h of age and at the 4th day old. Neurological outcomes were assessed at 1 year old. Results: Sixty-four neonates with perinatal asphyxia were enrolled. Fifty-eight (90%) had hypoxic-ischemic encephalopathy (HIE) including 20 (34%) Stage I, 21 (36%) Stage II, and 17 (29%) Stage III. In the asphyxiated infants without therapeutic hypothermia, HIE stage, PH, and base excess levels within 6 h of age were the predictors of adverse outcomes. In the asphyxiated infants receiving therapeutic hypothermia, HIE stage failed to predict outcomes. Instead, blood lactate levels and pulsatility index (PI) of medial cerebral arteries (MCA) either in 6 h of age or at the 4th day old independently predicted adverse outcomes. Conclusions: Blood lactate, which is a common accessible test at the hospital and MCA PI on cerebral ultrasound could predict adverse outcomes in asphyxiated infants receiving therapeutic hypothermia.Yi-Fang TuPo-Ming WuWen-Hao YuChung-I LiCheng-Lin WuLin KangYung-Chieh LinHsin-I ShihChao-Ching HuangMDPI AGarticleperinatal asphyxialactateneurological outcomesneonatal hypoxic-ischemic encephalopathyScienceQENLife, Vol 11, Iss 1193, p 1193 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	perinatal asphyxia lactate neurological outcomes neonatal hypoxic-ischemic encephalopathy Science Q
spellingShingle	perinatal asphyxia lactate neurological outcomes neonatal hypoxic-ischemic encephalopathy Science Q Yi-Fang Tu Po-Ming Wu Wen-Hao Yu Chung-I Li Cheng-Lin Wu Lin Kang Yung-Chieh Lin Hsin-I Shih Chao-Ching Huang Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study
description	Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the most common cause of mortality and neurological disability in infancy after perinatal asphyxia. Reliable biomarkers to predict neurological outcomes of neonates after perinatal asphyxia are still not accessible in clinical practice. Methods: A prospective cohort study enrolled neonates with perinatal asphyxia. Biochemical blood tests and cerebral Doppler ultrasound were measured within 6 h of age and at the 4th day old. Neurological outcomes were assessed at 1 year old. Results: Sixty-four neonates with perinatal asphyxia were enrolled. Fifty-eight (90%) had hypoxic-ischemic encephalopathy (HIE) including 20 (34%) Stage I, 21 (36%) Stage II, and 17 (29%) Stage III. In the asphyxiated infants without therapeutic hypothermia, HIE stage, PH, and base excess levels within 6 h of age were the predictors of adverse outcomes. In the asphyxiated infants receiving therapeutic hypothermia, HIE stage failed to predict outcomes. Instead, blood lactate levels and pulsatility index (PI) of medial cerebral arteries (MCA) either in 6 h of age or at the 4th day old independently predicted adverse outcomes. Conclusions: Blood lactate, which is a common accessible test at the hospital and MCA PI on cerebral ultrasound could predict adverse outcomes in asphyxiated infants receiving therapeutic hypothermia.
format	article
author	Yi-Fang Tu Po-Ming Wu Wen-Hao Yu Chung-I Li Cheng-Lin Wu Lin Kang Yung-Chieh Lin Hsin-I Shih Chao-Ching Huang
author_facet	Yi-Fang Tu Po-Ming Wu Wen-Hao Yu Chung-I Li Cheng-Lin Wu Lin Kang Yung-Chieh Lin Hsin-I Shih Chao-Ching Huang
author_sort	Yi-Fang Tu
title	Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study
title_short	Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study
title_full	Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study
title_fullStr	Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study
title_full_unstemmed	Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study
title_sort	lactate predicts neurological outcomes after perinatal asphyxia in post-hypothermia era: a prospective cohort study
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/735ef3bff9ef4d69a22fdf8066cd1220
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Lactate Predicts Neurological Outcomes after Perinatal Asphyxia in Post-Hypothermia Era: A Prospective Cohort Study

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