Lactate dehydrogenase in hypothermia-treated newborn infants with hypoxic-ischaemic encephalopathy
Article first published online: 27 JUL 2012
© 2012 The Author(s)/Acta Pædiatrica © 2012 Foundation Acta Pædiatrica
Volume 101, Issue 10, pages 1038–1044, October 2012
How to Cite
Thoresen, M., Liu, X., Jary, S., Brown, E., Sabir, H., Stone, J., Cowan, F. and Karlsson, M. (2012), Lactate dehydrogenase in hypothermia-treated newborn infants with hypoxic-ischaemic encephalopathy. Acta Paediatrica, 101: 1038–1044. doi: 10.1111/j.1651-2227.2012.02778.x
- Issue published online: 29 AUG 2012
- Article first published online: 27 JUL 2012
- Accepted manuscript online: 7 JUL 2012 08:35AM EST
- Received 23 April 2012; revised 25 June 2012; accepted 28 June 2012.
- Lactate dehydrogenase;
- Perinatal asphyxia
Aims: We investigated whether plasma lactate dehydrogenase (LDH) predicts outcome in hypothermia (HT)-treated term infants with moderate/severe hypoxic-ischaemic encephalopathy (HIE) and additionally whether LDH differs between infants with evidence for acute and nonacute perinatal insults and postnatal collapse (PNC).
Methods: Data from HT-treated infants with HIE (n = 39) were analysed retrospectively. Adverse outcome was defined as a Mental and/or Psychomotor Developmental Index (Bayley Scales of Infant Development II), at 18 months <70. The likely timing of insult onset was assessed in infants with an LDH sample obtained within 6 h of birth or PNC (n = 20).
Results: LDH differed between the favourable/adverse outcome groups at the end of HT treatment (median (IQR) 1540 (1400–1950)U/L vs. 3555 (3003–8705)U/L, (p < 0.01)). All infants (n = 22) with LDH <2085U/L had a favourable outcome while 6 of 11 infants with LDH ≥ 2085U/L had an adverse outcome. LDH in those who died (n = 4) was higher than the favourable outcome group (5090 (2915–12222)U/L, (p < 0.01)) but sampled earlier. Early LDH differed significantly (p < 0.01) between infants with evidence for acute or nonacute insults or PNC.
Conclusion: These results offer a biomarker, with high negative predictive value in the assessment of outcome in HT-treated term infants, needing prospective validation.