| Can tissue oxygenation index (TOI) and cotside neurophysiological variables predict outcome in depressed/asphyxiated newborn infants? | |
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MedLine Citation:
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PMID: 17052867 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Diagnostic tools of birth asphyxia provide only an uncertain prediction of neurological outcome. AIMS: To assess whether TOI and DeltaCBV, combined with a set of biochemical and neurophysiological variables, have any diagnostic and prognostic value in birth depression or asphyxia. STUDY DESIGN: Case control study at the nursery and NICU of the Padova University Children's Hospital. SUBJECTS: 22 term neonates with an Apgar score < or = 6 at 5', a 1-h umbilical artery pH value < or = 7.25 with an increased base deficit and a gestational age > or = 36 weeks; 15 healthy term infants with an Apgar score > or = 9 at 5'. OUTCOME MEASURES: Troponin I and NIRS measurements (TOI and DeltaCBV) were assessed in both groups. Blood gases, neurological evaluation, US, NIRS, EEG and SEP were evaluated in the infants with depression or asphyxia. RESULTS: Troponin I was higher in the study group than in controls (p=0.04), showing a correlation with base excess values. In the depressed/asphyxiated neonates with an abnormal outcome at 1 year, TOI rose to 80.1% vs 66.4% in controls (p=0.04) and 74.7% in infants with a normal 1-year outcome. A multiple regression model showed a significant multiple correlation coefficient, R=0.79, p<0.001, where the predictive variables significantly associated with outcome were SEP and BE. CONCLUSIONS: Troponin I is a useful short-term index of birth asphyxia or perinatal depression. An increased TOI suggests a risk of abnormal neurological outcome at 1 year. Among the cotside variables, BE and evoked potential abnormalities were the best predictors of abnormal outcome in this study. |
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Authors:
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Patrizia Zaramella; Elisabetta Saraceni; Federica Freato; Elena Falcon; Agnese Suppiej; Anna Milan; Anna Maria Laverda; Lino Chiandetti |
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Publication Detail:
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Type: Comparative Study; Journal Article Date: 2006-10-18 |
Journal Detail:
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Title: Early human development Volume: 83 ISSN: 0378-3782 ISO Abbreviation: Early Hum. Dev. Publication Date: 2007 Aug |
Date Detail:
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Created Date: 2007-07-31 Completed Date: 2007-10-11 Revised Date: 2008-11-21 |
Medline Journal Info:
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Nlm Unique ID: 7708381 Medline TA: Early Hum Dev Country: Ireland |
Other Details:
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Languages: eng Pagination: 483-9 Citation Subset: IM |
Affiliation:
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Department of Paediatrics, Neonatal Intensive Care Unit, University of Padova, Via Giustiniani, 3, 35128 Padova, Italy. zaramella@pediatria.unipd.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Asphyxia Neonatorum
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diagnosis*,
metabolism* Case-Control Studies Humans Infant, Newborn Nervous System Physiological Phenomena* Oxygen / metabolism* Prognosis |
| Chemical | |
Reg. No./Substance:
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7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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