title: Lactate dehydrogenase in hypothermia-treated newborn infants with hypoxic-ischaemic encephalopathy.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  THESE results offer a biomarker, with high negative predictive value in the assessment of outcome in HT-treated term infants, needing prospective validation.
authors: School of Clinical Sciences, University of Bristol, Bristol, UK. marianne.thoresen@bristol.ac.uk
authors: Marianne
authors: M
authors: Thoresen
authors: Xun
authors: X
authors: Liu
authors: Sally
authors: S
authors: Jary
authors: Emma
authors: E
authors: Brown
authors: Hemmen
authors: H
authors: Sabir
authors: Janet
authors: J
authors: Stone
authors: Frances
authors: F
authors: Cowan
authors: Mathias
authors: M
authors: Karlsson
mesh_terms: D001238:Asphyxia Neonatorum / Q000150:complications / Q000628:therapy*; D015415:Biomarkers; D016009:Chi-Square Distribution; D002658:Developmental Disabilities / Q000209:etiology*; D004739:England; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000150:complications / Q000628:therapy*; D007231:Infant, Newborn; D007234:Infant, Premature; D007770:L-Lactate Dehydrogenase / Q000097:blood*; D008297:Male; D017063:Outcome Assessment, Health Care; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors
chemical_list: D015415:Biomarkers; D007770:L-Lactate Dehydrogenase