Relationships between cardiovascular signs and neurological signs in asphyxiated neonates in Ilorin, North Central Nigeria

Abstract

Background: Perinatal asphyxia is a condition associated with multiple organ dysfunctions inclusive of cardiovascular dys- function. Neurologic predictors of survival have been studied, but little has been reported regarding cardiovascular signs and their role in determining outcome in asphyxia.
 Objective: The study aimed to determine the relationship between cardiovascular signs and outcomes in asphyxiated new- borns with hypoxic ischaemic encephalopathy.
 Methods: This was a cross sectional study involving asphyxiated new-born babies recruited within the first 24 hours of life. Hypoxic ischaemic encephalopathy staging was done using Sarnat and Sarnat staging. All patients had a detailed cardi- ovascular examination on admission, after initial resuscitation (30 – 60 minutes) into admission, and were followed till final outcome: discharge or death.
 Results: Eighty-five asphyxiated new-borns with HIE were studied over seven months. Abnormal cardiovascular-related signs identified in the patients included respiratory distress (64.7%), small volume pulse (57.6%), hypotension (52.9%), hy- poxemia (48.2%) and shock (32.9%). Five babies died. None of the clinical signs had a significant relationship with mortality.
 Conclusion: Abnormal cardiovascular signs increased with the progression of HIE staging but had no relationship with mortality.
 Keywords: Cardiovascular signs; Neurological outcomes; Mortality; Perinatal asphyxia.

Prevalence, case fatality rate and risk factors for mortality among neonates admitted with perinatal asphyxia at a tertiary hospital in northern Nigeria

“…However, cooling has not shown consisted outcomes especially from LMIC. 44 Three-quarters of neonates with an Apgar score of 0-3 at the 5 th minute died, this was significantly associated with an increase in death at the univariate level, which is similar to findings by Casey et al 45 who found a significant increase of mortality within 28 days of life in neonates with 5 minute Apgar score of 0-3, compared to less than 1% in those with a score of 4-6. 43 However, the Apgar score was not found to be a predictor of death at the multivariate level after adjusting for confounders.…”

Editorial: Infectious diseases and NCDs persist despite concerted effort

“…Now to the clinical. Nigerian clinicians have a paper on the relationships between ‘cardiovascular signs and neurological signs in asphyxiated neonates.’ 32 This paper is followed by several on sickle cell anemia: ‘the burden of iron overload among non-chronically blood transfused preschool children 33 ; disease severity and folate status 34 ; utilization and provider-related barriers to the use of hydroxyurea in the treatment of sickle cell disease patients, 35 and psycho-social problems of adolescents with sickle-cell anaemia. 36 The section ends with an interesting blood transfusion paper on the utility of ‘home-made’ reagent red blood cells for antibody screening during pre-transfusion compatibility testing in Uganda.…”