title: Acute systemic organ injury in term infants after asphyxia.
abstract: The systemic manifestations of "asphyxia" were evaluated prospectively in 35 consecutively intubated term newborn infants. The following systemic organ injuries were identified most often: (1) renal, ie, oliguria less than 1 mL/kg per hour for at lest 24 hours (40%), an elevated urinary beta-2-microglobulin concentration (57%), azotemia (11%), and an elevated serum creatinine level (17%); (2) central nervous system, ie, hypoxic-ischemic encephalopathy (including seizures) (31%) or an abnormal cranial ultrasound scan, ie, diffuse parenchymal echogenicity, slitlike ventricles, and poor visualization of the sulci, and/or intracranial hemorrhage (26%); (3) cardiovascular, ie, an abnormal echocardiogram (25%) or abnormal electrocardiogram (11%); (4) pulmonary complications, including persistent pulmonary hypertension (23%); and (5) gastrointestinal complications, which were rare. Traditional markers of fetal distress were not related to the frequency and/or distribution of systemic organ injury. An important implication of this study relates to the recognition of the extent and distribution of organ injury in the "asphyxiated" infant.
authors.affiliation: Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St Louis, Mo.
authors.forename: J M
authors.initials: JM
authors.lastname: Perlman
authors.forename: E D
authors.initials: ED
authors.lastname: Tack
authors.forename: T
authors.initials: T
authors.lastname: Martin
authors.forename: G
authors.initials: G
authors.lastname: Shackelford
authors.forename: E
authors.initials: E
authors.lastname: Amon
mesh_terms: D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000150:complications*; D002318:Cardiovascular Diseases / Q000209:etiology*; D002493:Central Nervous System Diseases / Q000209:etiology*; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007442:Intubation, Intratracheal; D007674:Kidney Diseases / Q000209:etiology*; D008171:Lung Diseases / Q000209:etiology*; D011446:Prospective Studies; D013997:Time Factors