Electrocardiographic and enzymatic correlations with outcome in neonates with hypoxic-ischemic encephalopathy

Italian Journal of Pediatrics

Om P Mishra²  Ajay Agrawal³  Nirmal Baral⁴  Prakash Poudel¹  Gauri S Shah¹  Jyoti Agrawal¹ 

[1] Departments of Pediatrics and Adolescent Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal;Department of Pediatrics, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India;Departments of Obstetrics and Gynecology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal;Departments of Biochemistry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

关键词: Myocardial dysfunction;    HIE;    Perinatal asphyxia;   

Others  :  825847
DOI  :  10.1186/1824-7288-38-33

 received in 2012-05-17, accepted in 2012-07-23,  发布年份 2012

【 摘 要 】

Background

Perinatal asphyxia leading to hypoxic-ischemic encephalopathy (HIE) is a common problem causing multi organ dysfunction including myocardial involvement which can affect the outcome.

Objective

To evaluate the myocardial dysfunction in neonates having HIE by electrocardiographic(ECG) and cardiac enzymes (CK Total, CK-MB and Troponin I) and find out the relationship with HIE and outcome.

Design/Methods

This was a hospital based prospective study. Sixty term neonates who had suffered perinatal asphyxia and developed HIE were enrolled. Myocardial involvement was assessed by clinical, ECG, and CK Total, CK-MB and Troponin I measurements.

Results

Of 60 cases, 13(21.7%) were in mild, 27(45%) in moderate and 20(33.3%) belonged to severe,HIE. ECG was abnormal in 46 (76.7%); of these 19 (41.3%) had grade I, 13 (28.2%) grades II and III each and 1 (2.1%) with grade IV changes. Serum levels of CK Total, CK- MB and Troponin I were raised in 54 (90%), 52 (86.6%) and 48 (80%) neonates, respectively. ECG changes and enzymatic levels showed increasing abnormalities with severity of HIE, and the differences among different grades were significant (p = 0.002, 0.02, <0.001 and 0.004, respectively). Nineteen (32%) cases died during hospital stay. The non- survivors had high proportion of abnormal ECG (p = 0.024), raised levels of CK-MB (p = 0.018) and Troponin I (p = 0.008) in comparison to survivors.

Conclusions

Abnormal ECG and cardiac enzymes levels are found in HIE and can lead to poor outcome due to myocardial damage Early detection can help in better management and survival of these neonates.

【 授权许可】

   
2012 Agarwal et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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