Blood gas measures as predictors for neonatal encephalopathy severity

Kullasate Sakpichaisakul; Krittin J Supapannachart; Mohamed El-DIb; Eniko Szakmar; Edward Yang; Brain H Walsh; Julian N Robinson; Sara Cherkerzian; Joseph J Volpe; Terrie E Inder

doi:10.1038/s41372-021-01075-w

Blood gas measures as predictors for neonatal encephalopathy severity

J Perinatol. 2021 Sep;41(9):2261-2269. doi: 10.1038/s41372-021-01075-w. Epub 2021 Jun 24.

Authors

Affiliations

¹ Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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.
³ Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
⁴ Department of Neonatology, Cork University Maternity Hospital, Cork, Ireland.
⁵ Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
⁶ Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.
⁷ Department of Pediatric Newborn Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. tinder@bwh.harvard.edu.

PMID: 34168288
DOI: 10.1038/s41372-021-01075-w

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 (R_ADJ² = 0.40), infant BD (R_ADJ² = 0.26), infant pH (R_ADJ² = 0.17), aUCG base deficit (R_ADJ² = 0.08), and aUCG lactate (R_ADJ² = 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.

MeSH terms

Fetal Blood
Humans
Hydrogen-Ion Concentration
Hypothermia, Induced*
Hypoxia-Ischemia, Brain* / diagnosis
Infant
Infant, Newborn
Infant, Newborn, Diseases*
Retrospective Studies