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Measurement of the Urinary Lactate:Creatinine Ratio for the Early Identification of Newborn Infants at Risk for Hypoxic-Ischemic Encephalopathy
NEJM 341:328-335,364, Huang,C.,et al, 1999
See this aricle in Pubmed
Article Abstract
Hypoxic-ischemic encephalopathy did not develop in any of the normal newborns but did develop in 16 of the 40 newborns with asphyxia. Within six hours after birth, the mean (+/=SD) ratio of urinary lactate to creatinine was 16.75 +/= 27.38 in the infants who subsequently had hypoxic-ischemic encephalopathy, as compared with 0.09 +/= 0.02 in the normal infants (P<0.001) and 0.19 +/= 0.12 in the infants with asphyxia in whom hypoxic-ischemi encephalopathy did not develop (P<0.001). A ratio of 0.64 or higher within six hours after birth had a sensitivity of 94 percent and a specificity of 100 percent for predicting the development of hypoxic-ischemic encephalopathy. The sensitivity and specificity of measurements obtained 48 to 72 hours aft er birth were much lower. The mean ratio of urinary lactate to creatinine was significantly higher in the infants who had adverse outcomes at one year (25.36 +/= 32.02) than in the infants with favorable outcomes (0.63 +/= 1.50) (P<0.001). Measurement o f the urinary lactate:creatinine ratio soon after birth may help identify infants at high risk for hypoxic-ischemic encephalopathy.
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encephalopathy,anoxic
encephalopathy,neonatal
hypoxia
hypoxia,newborn
hypoxic encephalopathy
neurologic disease,diagnoses of
urinary lactate:creatinine ratio
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