Younus Javaria, Hayat Sikandar, Haroon Farah, Irfan Waheed Khawaja Ahmad, Khan Mazhar Qadir, Khalid Muhammad Usman
Department of Neonatology, The Children's Hospital and The Institute of Child Health, Lahore, Pakistan.
J Ayub Med Coll Abbottabad. 2020 Apr-Jun;32(2):189-193.
Blood gases can provide information about the perinatal, natal and postnatal condition of newborn. Severity of metabolic acidosis has deleterious effect on the outcome of babies. When the cord blood gases are not available the arterial blood gases are used for interpreting the status of newborn. The purpose of study was to determine the relationship between severity of metabolic acidosis at admission with the stage of hypoxic ischemic encephalopathy, and its outcome in asphyxiated neonates.
This was descriptive cross-sectional study of 384 neonates born at ≥35 weeks to <42 weeks from June to December 2018, admitted in Neonatology department of the Children's hospital & the Institute of Child Health, Lahore within first 6 hours of birth. The neonates with history of delayed cry at birth and arterial pH ≤7.30 and base deficit ≥10 were included in the study. The pH and base deficit of babies was analyzed in relation to the stage of HIE, duration of stay and death or discharge of the babies using SPSS-20. The p-value was calculated using chi-square test.
Total of 470 neonates were eligible. Eighty-four neonates were excluded. Finally, 384 neonates were included and analyzed for the outcome variables. With severe metabolic acidosis pH <7.01, all the babies developed HIEII/III. Majority (82.1%) of the babies expired and 27.9% had prolonged hospital stay.
Increasing severity of metabolic acidosis at admission increases the likelihood of adverse outcome in asphyxiated neonates.
血气分析能够提供有关新生儿围产期、出生时及出生后状况的信息。代谢性酸中毒的严重程度会对婴儿的预后产生有害影响。当无法获取脐血气时,动脉血气可用于判断新生儿的状况。本研究的目的是确定入院时代谢性酸中毒的严重程度与缺氧缺血性脑病的阶段之间的关系,以及其在窒息新生儿中的预后情况。
这是一项描述性横断面研究,研究对象为2018年6月至12月出生的384例孕周≥35周且<42周的新生儿,这些新生儿在出生后的前6小时内被收入拉合尔儿童医院及儿童健康研究所新生儿科。纳入研究的新生儿需有出生时哭声延迟的病史,且动脉血pH≤7.30,碱剩余≥10。使用SPSS-20分析婴儿的pH值和碱剩余与缺氧缺血性脑病的阶段、住院时间以及婴儿的死亡或出院情况之间的关系。使用卡方检验计算p值。
共有470例新生儿符合条件。84例新生儿被排除。最终,384例新生儿被纳入并分析其结局变量。对于严重代谢性酸中毒(pH<7.01)的所有婴儿,均发展为II/III级缺氧缺血性脑病。大多数(82.1%)婴儿死亡,27.9%的婴儿住院时间延长。
入院时代谢性酸中毒严重程度的增加会增加窒息新生儿出现不良结局的可能性。