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Blood gas measures as predictors for neonatal encephalopathy severity

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Abstract

Objective

To correlate arterial umbilical cord gas (aUCG) and infant blood gas with severity of neurological injury.

Study design

Retrospective single-site study of infants evaluated for therapeutic hypothermia. Clinical neurological examination and a validated MRI scoring system were used to assess injury severity.

Results

Sixty-eight infants were included. aUCG base deficit (BD) and lactate correlated with infant blood gas counterparts (r = 0.43 and r = 0.56, respectively). aUCG and infant pH did not correlate. Infant blood gas lactate (RADJ2 = 0.40), infant BD (RADJ2 = 0.26), infant pH (RADJ2 = 0.17), aUCG base deficit (RADJ2 = 0.08), and aUCG lactate (RADJ2 = 0.11) were associated with clinical neurological examination severity. aUCG and infant blood gas measures were not correlated with MRI score.

Conclusion

Metabolic measures from initial infant blood gases were most associated with the clinical neurological examination severity and can be used to evaluate hypoxic-ischemic cerebral injury risk.

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Fig. 1: Scatterplots demonstrating the relationship between the arterial umbilical cord gas (aUCG), the initial infant blood gas measures, and the clinical neurological examination (NE) score.
Fig. 2: Scatterplots demonstrating the relationship between total MRI score with blood gas measures and the clinical neurological examination (NE) score.

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Acknowledgements

We thank Elizabeth Singh, Kirsten Thiim, and Song Ha Lee, our research assistants at BWH, for their assistance in collecting data.

Funding

This study was undertaken with local departmental funding support.

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Authors and Affiliations

  1. Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Kullasate Sakpichaisakul, Krittin J. Supapannachart, Mohamed El-DIb, Eniko Szakmar, Brain H. Walsh, Sara Cherkerzian, Joseph J. Volpe & Terrie E. Inder

  2. Division of Neurology, Department of Pediatrics, Queen Sirikit National Institute of Child Health, Ministry of Public Health, College of Medicine, Rangsit University, Bangkok, Thailand

    Kullasate Sakpichaisakul

  3. Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Edward Yang

  4. Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland

    Brain H. Walsh

  5. Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Julian N. Robinson

  6. Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA

    Joseph J. Volpe

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  1. Kullasate Sakpichaisakul
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Contributions

KS: had substantial contributions to conception and design, acquisition of data, analysis and interpretation of data, drafted the article, and had final approval of the version to be published. KJS: had substantial contributions to conception, acquisition of data, analysis and interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. MEl-D: had substantial contributions to conception and design, acquisition of data, interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. ES: had substantial contributions to acquisition of data, interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. EY: had substantial contributions to acquisition of data, interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. BHW: had substantial contributions to conception and design, acquisition of data, interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. JNR: had substantial contributions to conception and interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. SC: had substantial contributions to acquisition of data, analysis and interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. JJV: had substantial contributions to conception and interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published. TEI: had substantial contributions to conception and design, acquisition and interpretation of data, contributed to revising it critically for important intellectual content, and had final approval of the version to be published.

Corresponding author

Correspondence to Terrie E. Inder.

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Sakpichaisakul, K., Supapannachart, K.J., El-DIb, M. et al. Blood gas measures as predictors for neonatal encephalopathy severity. J Perinatol 41, 2261–2269 (2021). https://doi.org/10.1038/s41372-021-01075-w

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