Lactate predicts neurological outcomes after perinatal asphyxia in post-hypothermia era: A prospective cohort study

Yi Fang Tu, Po Ming Wu, Wen Hao Yu, Chung I. Li, Cheng Lin Wu, Lin Kang, Yung Chieh Lin, Hsin I. Shih, Chao Ching Huang

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Background: Neonatal hypoxic-ischemic encephalopathy (HIE) is the most common cause of mortality and neurological disability in infancy after perinatal asphyxia. Reliable biomarkers to predict neurological outcomes of neonates after perinatal asphyxia are still not accessible in clinical practice. Methods: A prospective cohort study enrolled neonates with perinatal asphyxia. Biochemical blood tests and cerebral Doppler ultrasound were measured within 6 h of age and at the 4th day old. Neurological outcomes were assessed at 1 year old. Results: Sixty-four neonates with perinatal asphyxia were enrolled. Fifty-eight (90%) had hypoxic-ischemic encephalopathy (HIE) including 20 (34%) Stage I, 21 (36%) Stage II, and 17 (29%) Stage III. In the asphyxiated infants without therapeutic hypothermia, HIE stage, PH, and base excess levels within 6 h of age were the predictors of adverse outcomes. In the asphyxiated infants receiving therapeutic hypothermia, HIE stage failed to predict outcomes. Instead, blood lactate levels and pulsatility index (PI) of medial cerebral arteries (MCA) either in 6 h of age or at the 4th day old independently predicted adverse outcomes. Conclusions: Blood lactate, which is a common accessible test at the hospital and MCA PI on cerebral ultrasound could predict adverse outcomes in asphyxiated infants receiving therapeutic hypothermia.

Original languageEnglish
Article number1193
JournalLife
Volume11
Issue number11
DOIs
Publication statusPublished - Nov 2021

Keywords

  • Lactate
  • Neonatal hypoxic-ischemic encephalopathy
  • Neurological outcomes
  • Perinatal asphyxia

ASJC Scopus subject areas

  • Ecology, Evolution, Behavior and Systematics
  • General Biochemistry,Genetics and Molecular Biology
  • Space and Planetary Science
  • Palaeontology

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