Changes in laboratory parameters indicating cell necrosis and organ dysfunction in asphyxiated neonates on moderate systemic hypothermia.
OBJECTIVE
Asphyxia is a major cause of morbidity and mortality in term infants. In addition to cerebral injury other organs are also distressed due to hypoxic-ischaemic insult. Systemic hypothermia has a beneficial effect on brain injury. We tested the impact of hypothermia on hypoxic damage of other internal organs.


METHODS
Asphyxiated term neonates (n = 21) were randomised to groups treated with hypothermia (n = 12) and normothermia (n = 9). Hypothermia (33-34 degrees C) was initiated within 6 h of life, and maintained for 72 h. We determined serum transaminase, lactate dehydrogenase, creatine kinase, uric acid, creatinine levels and diuresis during 6, 24, 48 and 72 postnatal hours.


RESULTS
Area under curve values of aspartate aminotransferase (ASAT), lactate dehydrogenase (LDH), uric acid and creatinine during the investigated period and alanine aminotransferase (ALAT) value at 72 h were lower in neonates on hypothermia than in those on normothermia. Renal failure and liver impairment affected less hypothermic than normothermic neonates (3/12 vs. 7/9, p = 0.03, 3/12 vs. 6/9 p = 0.08, respectively). Four of the 12 hypothermic and 6 of the 9 normothermic neonates developed multiorgan failure.


CONCLUSIONS
These results suggest that systemic hypothermia may protect against cell necrosis and tissue dysfunction of internal organs after neonatal asphyxia.
Róka
Anikó
A
First Department of Paediatrics, Semmelweis University, Budapest, Hungary. aniko.roka@gmail.com
Vásárhelyi
Barna
B
Bodrogi
Eszter
E
Machay
Tamás
T
Szabó
Miklós
M
D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D001238:Asphyxia Neonatorum / Q000097:blood* / Q000150:complications / Q000473:pathology / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D016923:Cell Death; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D007231:Infant, Newborn; D007770:L-Lactate Dehydrogenase / Q000097:blood; D009336:Necrosis / Q000097:blood; D018709:Statistics, Nonparametric; D013997:Time Factors; D014527:Uric Acid / Q000097:blood
D015415:Biomarkers; D014527:Uric Acid; D007770:L-Lactate Dehydrogenase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase