Predictive Value of Brain-Specific Proteins in Serum for Neurodevelopmental Outcome after Birth Asphyxia

Nagdyman, Nicole; Grimmer, I; Scholz, Tristess; Müller, Christian; Obladen, Michael

doi:10.1203/01.pdr.0000072518.98189.a0

Cited by 78 publications

(64 citation statements)

References 37 publications

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“…Although we did not check the CK isoenzymes at birth in our case, applying the CK -BB level to the above ratio, the level can be estimated to be 1,000 -3,500 IU/L. Nagdyman reported elevated serum CK -BB concentrations in infants with moderate or severe HIE within 24 hours after birth, with an average serum CK -BB level 46.5 IU/L (range, 21.4 -83.0 IU/L), but it was not correlated with long -term neurodevelopmental delays 10,11) . As those studies included few cases with high serum CK levels such as that reported herein, the serum CK -BB level was of limited value in predicting severe brain damage after birth asphyxia.…”

Section: Discussionmentioning

confidence: 99%

Brain Hypothermia Therapy for Neonatal Hypoxic-Ischemic Encephalopathy With a Severely Elevated Serum Creatine Kinase Level

Kinoshita

Imamura

Maeda

et al. 2015

FJMS

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: Several studies have shown that brain hypothermia therapy (BHT) after neonatal hypoxic -ischemic encephalopathy (HIE) can improve neurodevelopmental outcomes. However, there have been no reports of the neurodevelopmental outcomes for the infant with a serum creatine kinase (CK) level above 20,000 IU/L in association with neonatal HIE. We report a female infant with a very high serum CK level (26,428 IU/L) associated with neonatal asphyxia. We diagnosed this infant with moderate HIE, and BHT was achieved by head cooling within 6 hours after birth to an esophageal temperature of 34.5°C. There were no significant adverse events during BHT, and the CK level spontaneously decreased. Although we report only the short -term outcomes for this case, she presents neurodevelopmental delays at the age of 18 months. It may be correlated between high serum CK level and long -term neurodevelopmental delays. Abbreviations : CK, creatine kinase ; HIE, hypoxic -ischemic encephalopathy ; BHT, brain hypothermia therapy ; NRFS, non -reassuring fetal status ; CK -MB, creatine kinase -myocardial band ; MRI, magnetic resonance imaging ; CK -BB, creatine kinase -brain band.

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Section: Discussionmentioning

confidence: 99%

Brain Hypothermia Therapy for Neonatal Hypoxic-Ischemic Encephalopathy With a Severely Elevated Serum Creatine Kinase Level

Kinoshita

Imamura

Maeda

et al. 2015

FJMS

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“…Similarly, Nagdyman et al found that one-and five-minute APGAR scores of patients with asphyxia were statistically significantly lower than those of control group. 11 The APGAR scoring system has been established as an important predictor of prognosis in asphyxia cases.…”

Section: Discussionmentioning

confidence: 99%

Neonatal asphyxia: A study of 210 cases

Üzel

Kelekçi²,

Devecioğlu³

et al. 2012

J Clin Exp Invest

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ÖZETAmaç: Perinatal asfiksi, yenidoğan döneminin önemli mortalite ve morbidite nedenlerinden biridir. Bu çalış-manın amacı yenidoğan asfiksisi için antenatal, natal ve postnatal risk faktörlerini araştırmak, perinatal asfiksili yenidoğanlarda bilinen risk faktörleri ile Sarnat ve Sarnat skorları ilişkisini ve risk faktörlerinin hastanede kalış süre-si ve sağkalım ile ilişkisini belirlemektir. Gereç ve yöntem:Bu çalışmada perinatal asfiksi tanısı alan 210 vakanın dosya kayıtları geriye dönük olarak incelendi. Hastaların demografik özellikleri, risk faktörleri ve Sarnat and Sarnat klinik evreleme özellikleri analiz edildi. Bulgular:Hastaların %67,7'sinde antepartum, %91'inde intrapartum ve %29,5'inde postpartum risk faktörü bulunmaktaydı. Yıllara göre incelendiğinde perinatal asfiksili olgu %28,1 oranında en fazla 2007 yılında görülürken yıllar içinde bir düşüş ile birlikte %21 oranında 2010 yı-lında tanı almıştı ve evre 3 olgu sayısı ve mortalite oranı anlamlı şekilde azalmıştı (p<0.05).Sonuç: Doğum sırasında ki daha az önlenebilir doğum asfiksisi nedenleri daha sık görülmektedir. Risk faktörleri-nin erken tespit edilmesi yanında uygun prenatal, natal ve postnatal bakım, düşük APGAR skorlu ve acil sezeryan doğumların azalması perinatal asfiksi sıklığını önemli öl-çüde azaltacaktır. Yoğun bakım ihtiyacı ve resüsitasyon yapılan yenidoğanların yeterli donanıma sahip merkezlerde izlenmesi de asfiksiye bağlı komplikasyonları azaltacağını düşünüyoruz.Anahtar kelimeler: Asfiksi, yenidoğan, risk faktörü, prognoz ABSTRACT Objectives: Perinatal asphyxia remains an important cause of neonatal morbidity and mortality. The aim of this study was to investigate antenatal, natal, and postnatal risk factors of neonatal asphyxia, relationship with known risk factors and stage of Sarnat and Sarnat scores, the effect of risk factors on hospital discharge and survival for neonates with perinatal asphyxia. Materials and methods:In this study, we retrospectively analyzed the hospital records of 210 patients diagnosed as perinatal asphyxia. The patients' demographic characteristics, antepartum, intrapartum, and postpartum risk factors and Sarnat and Sarnat clinical staging criteria of newborns were analyzed. Results:The risk factors for asphyxia were detected antepartum period in 67.7% of newborns, intrapartum in 91% and potpartum in of 29.5% of neonates. When cases were examined according to the studied years, perinatal asphyxia ratio was the most frequent in 2007 as 28.1%. With a decline over the years, frequency dropped to %21 in 2010. The number of patients with stage 3 and mortality rate were significantly decreased over the years (p <0.05). Conclusions:Less preventable intrapartum causes of birth asphyxia are seen more frequently. Early detection of risk factors together with appropriate prenatal, natal and postnatal care provision, reduced emergency caesarean sections and will decrease considerably decrease frequency of perinatal asphyxia. We think that following up neonates who needed intensive care in neonatal units sufficientl...

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“…Although these biomarkers are apparently specific for neural tissue, they have not been shown to be consistently elevated in HIE or correlated with outcome. Nagdyman et al 42 found that CK-BB and S100b were elevated in term infants with HIE, while NSE levels were not. None of the biomarkers correlated with death or disability at 20 months of age.…”

Section: Biochemical Biomarkersmentioning

confidence: 99%

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

Merchant

Azzopardi

2015

Develop Med Child Neuro

100

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Hypoxic–ischaemic encephalopathy (HIE) is a leading cause of acquired neonatal brain injury. Assessment of the severity of cerebral injury and likely neurological outcome in infants with HIE is important for determining management and prognosis, for counselling parents, and for selection for neuroprotective trials. The condition of the infant at birth, the severity of HIE, neurophysiological tests, including amplitude‐integrated electroencephalography (aEEG), biochemical markers, and neuroimaging have been used to assess prognosis and predict long‐term outcome. The predictive accuracy of these indicators in the early postnatal period is modest. Neurophysiological assessment seems to be most helpful during the first 24 to 48 hours after birth whilst magnetic resonance imaging (MRI) seems most informative later. Several biochemical markers, including serum S100β and neuron‐specific enolase (NSE), are also associated with HIE but their levels depend on the timing of sampling and their prognostic value is uncertain. Comprehensive neurophysiological assessment and neuroimaging may be limited to specialist centres. Therapeutic hypothermia is now standard care in infants with moderate to severe HIE so it is important to examine the influence of hypothermia on the assessment of prognosis in these infants.

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Predictive Value of Brain-Specific Proteins in Serum for Neurodevelopmental Outcome after Birth Asphyxia

Cited by 78 publications

References 37 publications

Brain Hypothermia Therapy for Neonatal Hypoxic-Ischemic Encephalopathy With a Severely Elevated Serum Creatine Kinase Level

Brain Hypothermia Therapy for Neonatal Hypoxic-Ischemic Encephalopathy With a Severely Elevated Serum Creatine Kinase Level

Neonatal asphyxia: A study of 210 cases

Early predictors of outcome in infants treated with hypothermia for hypoxic–ischaemic encephalopathy

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