PubMed · 14606237
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Andrea Mühlbacher, Sandra Hogrefe. 2002. [Background information on ST analysis].. https://pubmed.ncbi.nlm.nih.gov/14606237/
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BACKGROUND: Diagnostic tools of birth asphyxia provide only an uncertain prediction of neurological outcome. AIMS: To assess whether TOI and DeltaCBV, combined with a set of biochemical and neurophysiological variables, have any diagnostic and prognostic value in birth depression or asphyxia. STUDY DESIGN: Case control study at the nursery and NICU of the Padova University Children's Hospital. SUBJECTS: 22 term neonates with an Apgar score < or = 6 at 5', a 1-h umbilical artery pH value < or = 7.25 with an increased base deficit and a gestational age > or = 36 weeks; 15 healthy term infants with an Apgar score > or = 9 at 5'. OUTCOME MEASURES: Troponin I and NIRS measurements (TOI and DeltaCBV) were assessed in both groups. Blood gases, neurological evaluation, US, NIRS, EEG and SEP were evaluated in the infants with depression or asphyxia. RESULTS: Troponin I was higher in the study group than in controls (p=0.04), showing a correlation with base excess values. In the depressed/asphyxiated neonates with an abnormal outcome at 1 year, TOI rose to 80.1% vs 66.4% in controls (p=0.04) and 74.7% in infants with a normal 1-year outcome. A multiple regression model showed a significant multiple correlation coefficient, R=0.79, p<0.001, where the predictive variables significantly associated with outcome were SEP and BE. CONCLUSIONS: Troponin I is a useful short-term index of birth asphyxia or perinatal depression. An increased TOI suggests a risk of abnormal neurological outcome at 1 year. Among the cotside variables, BE and evoked potential abnormalities were the best predictors of abnormal outcome in this study.
This study investigated the effect of myocardial dysfunction on the cerebral hemodynamics in term infants with hypoxic-ischemic encephalopathy (HIE). We evaluated myocardial systolic and diastolic functional parameters and cerebral hemodynamic parameters in 40 term newborn infants with HIE and 30 healthy controls during the first 14 days of life using two-dimensional/pulsed Doppler ultrasound. The results showed that there were significant cerebral hemodynamic disturbances and cardiac dysfunction in neonates with HIE, and the more cardiac dysfunction the patients have, the more severe encephalopathy they would suffer. Therefore, it is important to preserve cardiac function and treat myocardial dysfunction in infants with HIE.
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