- Visibility 102 Views
- Downloads 85 Downloads
- Permissions
- DOI 10.18231/pjms.v.15.i.2.292-297
-
CrossMark
CK-MB and LDH as predictor of HIE in term babies born with perinatal asphyxia
- Author Details:
-
Jesmin Hussain *
-
Anupama Deka
-
Ipsita Mahapatra
Jesmin Hussain *
Ipsita Mahapatra
Background: One prevalent issue affecting newborns is perinatal asphyxia, which has a substantial impact on the morbidity and mortality of newborns. Perinatal asphyxia can affect all the organ systems with a higher predilection for the nervous system resulting in neurological dysfunction which has been termed Hypoxic Ischemic Encephalopathy (HIE). It has been discovered that LDH and CK-MB have great sensitivity and specificity and that the results of these tests can be obtained right away at the bedside. Following asphyxia, there is a significant increase in LDH and CK-MB, which indicates that these enzymes may be useful in predicting the degree of hypoxic-ischaemic insult a newborn would experience.
Aims: 1: To evaluate the serum CK-MB and LDH levels among asphyxiated and non-asphyxiated term neonates; 2: To study whether these enzymes (if raised) can be used to predict the development of Hypoxic Ischaemic Encephalopathy (HIE) and its correlation with HIE staging.
Materials and Methods: Newborns with perinatal asphyxia were used as cases in this prospective case-control research, whereas healthy term neonates were used as controls. Blood for CK-MB had been drawn at 8 ± 2hrs. of birth as well as LDH at 72 ± 2 hrs of birth.
Results: When comparing the levels of CK-MB as well as LDH in cases versus controls, a significant p value of 0.001 was obtained. LDH was found to have more sensitivity & specificity than CK-MB and hence was found to have more diagnostic accuracy. Babies that died due to HIE 3 had marked elevation of both biomarker levels as compared to other cases of asphyxia.
Conclusion: 1. LDH at 72±2 hours of birth was found to be a better diagnostic test than CK-MB for detecting HIE in cases of perinatal asphyxia; 2. LDH and CK-MB can be utilized to correlate the degree of HIE in cases of birth asphyxia.
References
- Giesinger RE, Bailey LJ, Deshpande P, McNamara PJ. Hypoxic- Ischemic Encephalopathy and Therapeutic Hypothermia: The Hemodynamic Perspective. J Pediatr. 2017:180:22-30.e2.
- Tooly J. Perinatal asphyxia and Hypoxic-ischemic encephalopathy. Perinatal /Neonatal medicine. In: Mclntosh N, Helms P , Smyth R, Logan S, editors. Forfar and Arneil's textbook of Pediatrics. 7th edition Philadelphia: Churchill Livingstone, an imprint of Elsevier Ltd; 2003. p. 204–7.
- Warburton D, Singer DB, Oh W. Effects of acidosis on the activity of creatine phosphokinase and its isoenzymes in the serum of newborn infants. Pediatrics 1931;68(2):195–7.
- Sankar MJ, Neogi SB, Paul VK, State of newborn health in India. J Perinatol. 2016;36(s3):S3-S8.
- Power B, Mc Ginley J. The Modified Sarnat Score in the Assessment of Neonatal Encephalopathy: A Quality Improvement Initiative. Ir Med J. 2019;112;(7):976.
- Instructions for use CK -MB. https://paperzz.com/doc/8433313/instructions-for-use-ck-mb
- Pesce MA. Reference ranges for laboratory tests and procedures. In: Kliegman RM Behrman RE, Jenson HB, Stanton BF, eds. Nelson textbook of Pediatrics. 18th edition. Philadelphia: Saunders, 2007. p. 2943–54.
- Reddy S, Dutta S, Narang A. Evaluation of Lactate Dehydrogenase, Creatine Kinase and Hepatic Enzymes for the Retrospective Diagnosis of Perinatal Asphyxia Among Sick Neonates. Indian Pediatr. 2008;45(2):144–7.
- Chawla S, Singh R, Bhatta N. Lactate dehydrogenase and CK-MB as predictors of hypoxic ischaemic encephalopathy in newborns with perinatal asphyxia. MedPulse Int J Pediatr. 2019;11(2):58–64
- Meena K, Soni R.K, Ahmed N, Nitesh, Harsh P. Evaluation of Serum Creatine Kinase Muscle-Brain Fraction (CK-MB) and Lactate Dehydrogenase (LDH) as markers of Perinatal asphyxia in term neonates at tertiary health care centre in Bikaner. J Med Sci Clin Res. 2017;5(5):22193–8.
- AbouZied H , Ali Khalifa N, Heeblu Loudeeni M, Abdel-Raouf El- Shaarawy S. Role of Creatine Kinase MB in Diagnosis of Myocardial Injury after Neonatal Hypoxia-Ischemia. Egyp J Hosp Med. 2021;85(2):3498–502.
- Abdelbaseer K, Abdalla E, Ibraheem A, Qubaisy H. The role of serum lactate and enzymes in predicting perinatal asphyxia. SVU- Int J Med Sci. 2021;5(2):262–73.
- Hassan B, Maryam Z, Ali M. Predictive value of biochemical and hematological markers in prognosis of asphyxic infants. Caspian J Intern Med. 2020;11(4):377–83.
- Acharya A, Swain B, Pradhan S, Jena KP, Mohakud KN, Swain Arakhita, Mohanty N, Clinico-Biochemical Correlation in Birth Asphyxia and Its Effects on Outcome; Cureus. 2020;12(11): e11407.
- T. Ogundele, S.B. Oseni, J. Owa, O. Ogundele: Lactate Dehydrogenase, Aspartate Aminotransferase, and Alanine Aminotransferase Cord Serum Levels as Early Markers of Hypoxic– Ischemic Encephalopathy in Babies with Severe Perinatal Asphyxia. J Pediatr Neurol. 2018;17(3).