Abstract
Asphyxia in the term infant is the most common cause of poor perinatal outcome. The aim of our study was to identify early, severe brain damage a ter perinatal asphyxia by demonstrating lactate accumulation in the brain with proton-MR-spectroscopy (H-MRS) and cerebral hyperperfusion by xenon-133 clearance. We included 18 mature infants, appropriate for gestational age, with a mean umbilical pH of 6.95 (6.73-7.19) and an Apgar score at five minutes ranging from 1-10 (mean 4.5). Cerebral blood flow (CBF) was determined daily in the first three days after birth and an early H-MRS was carried out at day 0-7 (mean 3.3). Results at five month of age was that four infants had died within the first week, three showed moderate to severe neurological deficits and eleven infants appeared to be progressing normally at this time. Lactate accumulation in the brain (P = 0.0003) and high CBF (p=0.02) were highly associated with severe outcome, and infants who survived with handicap had prolonged lactate accumulation in the brain and persistently low NAA/Cho (N-acetyl-aspartate/choline, (p = 0.009)) as compared to normal infants. In conclusion, early H-MRS and CBF are highly predictive of poor outcome in severely asphyxiated infants.
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Leth, H., Toft, P., Pryds, O. et al. 125 PROTON MR SPECTROSCOPY AND CBF TO PREDICT OUTCOME AFTER PERINATAL ASPHYXIA. Pediatr Res 36, 23 (1994). https://doi.org/10.1203/00006450-199407000-00125
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DOI: https://doi.org/10.1203/00006450-199407000-00125
