A comparative study of serum creatine kinase muscle-brain fraction (CK-MB) and lactate dehydrogenase (LDH) levels among asphyxiated and Non-asphyxiated term neonates

Abstract

Background: For differentiating an asphyxiated from a non-asphyxiated neonate with reasonable degree of precision, estimation of serum levels of CK-MB and LDH can play a crucial role. Methods: This hospital based study was conducted for a period of one year at tertiary care teaching hospital of Jaipur, Rajasthan in asphyxiated (Cases) and non-asphyxiated (Controls) term neonates. Creatine Kinase Muscle-Brain fraction (CK-MB) levels at 8 hours and 24 hours and Lactate Dehydrogenase (LDH) levels were measured. Sensitivity, specificity and positive predictive value and negative predictive value of the test were performed. ROC Curve analysis has been performed to find the diagnostic performance of CK-MB and LDH. Results: Statistically significant difference was found with elevated CK-MB levels at 8 hours and at 24 hours respectively among cases as compared to control (p<0.05). The number of neonates with LDH > 580 U/L (cut off value) was significantly more in cases when compared to controls (p<0.05). The correlation of Low Apgar score at 1 minute and 5 minute, CK-Mb at 8 hours, 24 hours and LDH with stages of Hypoxic ischemic encephalopathy (HIE) was found to be statistically significant (p<0.05). Conclusion:This study concluded that all these markers can be very advantageous in differentiating neonates with asphyxia and without asphyxia which will further help in appropriate management and better outcome of these newborns.