title: Using adrenaline during neonatal resuscitation may have an impact on serum cardiac troponin-T levels.
abstract: OBJECTIVE
  It has been suggested that serum cardiac troponin-T (cTnT) can predict the severity of neonatal hypoxic-ischaemic encephalopathy. We evaluated whether cTnT was better correlated with adrenaline during cardiopulmonary resuscitation (CPR) than with the severity of the insult itself, based on the Apgar scores.
  
  
  METHODS
  Serum cTnT was analysed in 47 asphyxiated newborn infants treated with hypothermia. Blood samples and resuscitation data were collected from medical records, and multiple linear regressions were used to evaluate the effect of the treatment and the Apgar scores on cTnT levels.
  
  
  RESULTS
  The infants were divided into three groups: the no CPR group (n = 29) just received stimulation and ventilation, the CPR minus adrenaline group (n = 9) received cardiac compression and ventilation and the CPR plus adrenaline group (n = 9) received complete CPR, including adrenaline. In the univariate analysis, the five and ten-minute Apgar scores were significantly lower in the CPR plus adrenaline group and the cTnT was significantly higher. Multiple regression analysis showed significantly higher cTnT values in the CPR plus adrenaline group, but no significant relationship between cTnT and the Apgar scores.
  
  
  CONCLUSIONS
  Although cTnT correlated with the severity of the insult in neonatal hypoxic-ischaemic encephalopathy, the levels may have been affected by adrenaline administered during CPR.
authors.affiliation: Faculty of Medicine, Medical School, University of Oslo, Oslo, Norway.
authors.forename: Caroline
authors.initials: C
authors.lastname: Helmer
authors.affiliation: Department of Neonatal Intensive Care, Oslo University Hospital Ullevål, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Janne H
authors.initials: JH
authors.lastname: Skranes
authors.affiliation: Institute of Informatic, University of Oslo, Oslo, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Liestøl
authors.affiliation: Department of Neonatal Intensive Care, Oslo University Hospital Ullevål, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
authors.forename: Drude
authors.initials: D
authors.lastname: Fugelseth
mesh_terms: D001034:Apgar Score; D001238:Asphyxia Neonatorum / Q000097:blood / Q000628:therapy*; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D016887:Cardiopulmonary Resuscitation; D015331:Cohort Studies; D004837:Epinephrine / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000097:blood* / Q000628:therapy; D007231:Infant, Newborn; D008297:Male; D020107:Troponin T / Q000097:blood*
chemical_list: D001993:Bronchodilator Agents; D020107:Troponin T; D004837:Epinephrine
keywords: Apgar scores; Cardiac troponin-T; Cardiopulmonary resuscitation; Hypoxic-ischaemic encephalopathy; Newborn infants