Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy
Background: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided...
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MDPI AG
2021-05-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/11/5/897 |
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| author | Inn-Chi Lee Swee-Hee Wong Xing-An Wang Chin-Sheng Yu |
| author_facet | Inn-Chi Lee Swee-Hee Wong Xing-An Wang Chin-Sheng Yu |
| author_sort | Inn-Chi Lee |
| collection | DOAJ |
| description | Background: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided into group 1 (mild HIE) and group 2 (moderate or severe HIE). Then, 42 patients from group 2 received hypothermia therapy and were further divided into group 3 (unremarkable or mild MRI results) and group 4 (severe MRI results). Results: Between groups 1 and 2, lactate, creatinine, white blood cells, and lactate dehydrogenase (LDH) were significantly different. Between groups 3 and 4, lactate, prothrombin time, and albumin were significantly different. Sarnat staging was based on our observation that more than 45 mg/dL of lactate combined with more than 1000 U/L of LDH yielded the highest positive predictive value (PPV) (95.7%; odds ratio, 22.00), but a low negative predictive value (NPV) for moderate or severe HIE. Using more than 45 mg/dL of lactate yielded the highest NPV (71.4%) correlated with moderate or severe HIE. Conclusions: Lactate combined with LDH before 6 h after birth yielded a high PPV. Using combined biomarkers to exclude mild HIE, include moderate or severe HIE, and initialize hypothermia therapy is feasible. |
| first_indexed | 2024-03-10T11:17:57Z |
| format | Article |
| id | doaj.art-41eb17d73411425dbd38aa053f5114d9 |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T11:17:57Z |
| publishDate | 2021-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-41eb17d73411425dbd38aa053f5114d92023-11-21T20:15:25ZengMDPI AGDiagnostics2075-44182021-05-0111589710.3390/diagnostics11050897Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic EncephalopathyInn-Chi Lee0Swee-Hee Wong1Xing-An Wang2Chin-Sheng Yu3Division of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, TaiwanDivision of Pediatric Neurology, Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 40201, TaiwanInstitute of Medicine, School of Medicine, Chung Shan Medical University, Taichung 40201, TaiwanDepartment of Information Engineering and Computer Science, and Master’s Program in Biomedical Informatics and Biomedical Engineering, Feng Chia University, Taichung 40201, TaiwanBackground: Identifying an effective method for the early diagnosis of neonatal hypoxic-ischemic encephalopathy (HIE) would be beneficial for effective therapies. Methods: We studied blood biomarkers before 6 h after birth to correlate the degree of neonatal HIE. A total of 80 patients were divided into group 1 (mild HIE) and group 2 (moderate or severe HIE). Then, 42 patients from group 2 received hypothermia therapy and were further divided into group 3 (unremarkable or mild MRI results) and group 4 (severe MRI results). Results: Between groups 1 and 2, lactate, creatinine, white blood cells, and lactate dehydrogenase (LDH) were significantly different. Between groups 3 and 4, lactate, prothrombin time, and albumin were significantly different. Sarnat staging was based on our observation that more than 45 mg/dL of lactate combined with more than 1000 U/L of LDH yielded the highest positive predictive value (PPV) (95.7%; odds ratio, 22.00), but a low negative predictive value (NPV) for moderate or severe HIE. Using more than 45 mg/dL of lactate yielded the highest NPV (71.4%) correlated with moderate or severe HIE. Conclusions: Lactate combined with LDH before 6 h after birth yielded a high PPV. Using combined biomarkers to exclude mild HIE, include moderate or severe HIE, and initialize hypothermia therapy is feasible.https://www.mdpi.com/2075-4418/11/5/897newbornhypoxic-ischemic encephalopathybiomarkerMRIlactate |
| spellingShingle | Inn-Chi Lee Swee-Hee Wong Xing-An Wang Chin-Sheng Yu Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy Diagnostics newborn hypoxic-ischemic encephalopathy biomarker MRI lactate |
| title | Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy |
| title_full | Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy |
| title_fullStr | Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy |
| title_full_unstemmed | Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy |
| title_short | Identifying Early Diagnostic Biomarkers Associated with Neonatal Hypoxic-Ischemic Encephalopathy |
| title_sort | identifying early diagnostic biomarkers associated with neonatal hypoxic ischemic encephalopathy |
| topic | newborn hypoxic-ischemic encephalopathy biomarker MRI lactate |
| url | https://www.mdpi.com/2075-4418/11/5/897 |
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