title: Low adjusted serum ionized calcium concentration shortly after birth predicts poor outcome in neonatal hypoxic-ischemic encephalopathy.
abstract: OBJECTIVE
  Hypoxic-ischemic reperfusion injury causes either necrosis or apoptosis, and the influx of ionized calcium into cells is the major cause of both types of cell death. The aim of this study was to investigate whether or not the serum ionized calcium concentration in neonates with hypoxic-ischemic encephalopathy (HIE) could be used to predict their outcome.
  
  
  METHODS
  Serum samples were obtained shortly after birth from 20 HIE neonates who had not urinated or received treatment with calcium. Serum ionized calcium concentrations were adjusted for pH using a correction formula. Twelve neonates without any disease were selected as a control. The results were compared between nine HIE neonates who made a full recovery, 11 who died or had neurologic deficits, and 12 normal neonates.
  
  
  RESULTS
  Considered together, the two HIE groups had lower serum ionized calcium concentrations (1.05 +/- 0.10 mmol/L) than the control group (1.22 +/- 0.07 mmol/L; P < 0.0001). Moreover, serum ionized calcium concentrations in the group with the poor outcome (0.99 +/- 0.07 mmol/L) were lower than those in the group that made a full recovery (1.13 +/- 0.06 mmol/L; P=0.0016).
  
  
  CONCLUSIONS
  The serum ionized calcium concentrations shortly after birth were significantly lower in neonates with HIE who had a poor outcome. Low concentrations may reflect multiple organ damage, particularly involving the brain.
authors.affiliation: Department of Obstetrics and Gynecology, Toyama Medical and Pharmaceutical University, Toyama, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yoneda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ibara
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kobayashi
authors.forename: Eiji
authors.initials: E
authors.lastname: Kato
authors.forename: Yuko
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Hideki
authors.initials: H
authors.lastname: Maruyama
authors.forename: Yumi
authors.initials: Y
authors.lastname: Sumida
authors.forename: Rei
authors.initials: R
authors.lastname: Sunami
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Sakai
authors.forename: Tsuyomu
authors.initials: T
authors.lastname: Ikenoue
authors.forename: Shigeru
authors.initials: S
authors.lastname: Saito
mesh_terms: D001238:Asphyxia Neonatorum / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D002118:Calcium / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000097:blood / Q000175:diagnosis; D007231:Infant, Newborn; D008297:Male; D011237:Predictive Value of Tests
chemical_list: D015415:Biomarkers; D002118:Calcium