Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature)
Abstract Objective To evaluate whether a secondary increase of serum lactate levels in asphyxiated newborns during hypothermia treatment may reflect suboptimal dynamics. Methods–Retrospective case series and review of the literature. We present the clinical course of four a...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2016-03-01
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| Series: | American Journal of Perinatology Reports |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1565921 |
| _version_ | 1819049592663048192 |
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| author | Asim Al Balushi Marie-Pier Guilbault Pia Wintermark |
| author_facet | Asim Al Balushi Marie-Pier Guilbault Pia Wintermark |
| author_sort | Asim Al Balushi |
| collection | DOAJ |
| description | Abstract
Objective To evaluate whether a secondary increase of serum lactate levels in asphyxiated newborns during hypothermia treatment may reflect suboptimal dynamics.
Methods–Retrospective case series and review of the literature. We present the clinical course of four asphyxiated newborns treated with hypothermia who presented with hypotension requiring inotropic support, and who displayed a secondary increase of serum lactate levels during hypothermia treatment. Serial serum lactate levels are correlated with blood pressure and inotropic support within the first 96 hours of life.
Results Lactate levels initially decreased in the four patients. However, each of them started to present lower blood pressure, and lactate levels started to increase again. Inotropic support was started to raise blood pressure. The introduction of an epinephrine drip consistently worsened the increase of lactate levels in these newborns, whereas dopamine and dobutamine enabled the clearance of lactate in addition to raising the blood pressure. Rewarming was associated with hemodynamics perturbations (a decrease of blood pressure and/or an increase of lactate levels) in the three newborns who survived.
Conclusions Lactate levels during the first 4 days of life should be followed as a potential marker for suboptimal hemodynamic status in term asphyxiated newborns treated with hypothermia, for whom the maintenance of homeostasis during hypothermia treatment is of utmost importance to alleviate brain injury. |
| first_indexed | 2024-12-21T11:34:36Z |
| format | Article |
| id | doaj.art-d5b686515f8447c693865caf1f2b9020 |
| institution | Directory Open Access Journal |
| issn | 2157-6998 2157-7005 |
| language | English |
| last_indexed | 2024-12-21T11:34:36Z |
| publishDate | 2016-03-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | American Journal of Perinatology Reports |
| spelling | doaj.art-d5b686515f8447c693865caf1f2b90202022-12-21T19:05:28ZengThieme Medical Publishers, Inc.American Journal of Perinatology Reports2157-69982157-70052016-03-010601e48e5810.1055/s-0035-1565921Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature)Asim Al Balushi0Marie-Pier Guilbault1Pia Wintermark2Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, CanadaDepartment of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, CanadaDivision of Newborn Medicine, Department of Pediatrics, Montreal Children's Hospital, McGill University, Montreal, CanadaAbstract Objective To evaluate whether a secondary increase of serum lactate levels in asphyxiated newborns during hypothermia treatment may reflect suboptimal dynamics. Methods–Retrospective case series and review of the literature. We present the clinical course of four asphyxiated newborns treated with hypothermia who presented with hypotension requiring inotropic support, and who displayed a secondary increase of serum lactate levels during hypothermia treatment. Serial serum lactate levels are correlated with blood pressure and inotropic support within the first 96 hours of life. Results Lactate levels initially decreased in the four patients. However, each of them started to present lower blood pressure, and lactate levels started to increase again. Inotropic support was started to raise blood pressure. The introduction of an epinephrine drip consistently worsened the increase of lactate levels in these newborns, whereas dopamine and dobutamine enabled the clearance of lactate in addition to raising the blood pressure. Rewarming was associated with hemodynamics perturbations (a decrease of blood pressure and/or an increase of lactate levels) in the three newborns who survived. Conclusions Lactate levels during the first 4 days of life should be followed as a potential marker for suboptimal hemodynamic status in term asphyxiated newborns treated with hypothermia, for whom the maintenance of homeostasis during hypothermia treatment is of utmost importance to alleviate brain injury.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1565921birth asphyxiahemodynamicslactateneonatal encephalopathynewborn brain |
| spellingShingle | Asim Al Balushi Marie-Pier Guilbault Pia Wintermark Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature) American Journal of Perinatology Reports birth asphyxia hemodynamics lactate neonatal encephalopathy newborn brain |
| title | Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature) |
| title_full | Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature) |
| title_fullStr | Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature) |
| title_full_unstemmed | Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature) |
| title_short | Secondary Increase of Lactate Levels in Asphyxiated Newborns during Hypothermia Treatment: Reflect of Suboptimal Hemodynamics (A Case Series and Review of the Literature) |
| title_sort | secondary increase of lactate levels in asphyxiated newborns during hypothermia treatment reflect of suboptimal hemodynamics a case series and review of the literature |
| topic | birth asphyxia hemodynamics lactate neonatal encephalopathy newborn brain |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0035-1565921 |
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