Acute systemic organ injury in term infants after asphyxia
J. M. Perlman, E. D. Tack, T. Martin, G. Shackelford and E. Amon
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St Louis, Mo.
The systemic manifestations of "asphyxia" were evaluated prospectively in
35 consecutively intubated term newborn infants. The following systemic
organ injuries were identified most often: (1) renal, ie, oliguria less
than 1 mL/kg per hour for at lest 24 hours (40%), an elevated urinary
beta-2-microglobulin concentration (57%), azotemia (11%), and an elevated
serum creatinine level (17%); (2) central nervous system, ie,
hypoxic-ischemic encephalopathy (including seizures) (31%) or an abnormal
cranial ultrasound scan, ie, diffuse parenchymal echogenicity, slitlike
ventricles, and poor visualization of the sulci, and/or intracranial
hemorrhage (26%); (3) cardiovascular, ie, an abnormal echocardiogram (25%)
or abnormal electrocardiogram (11%); (4) pulmonary complications, including
persistent pulmonary hypertension (23%); and (5) gastrointestinal
complications, which were rare. Traditional markers of fetal distress were
not related to the frequency and/or distribution of systemic organ injury.
An important implication of this study relates to the recognition of the
extent and distribution of organ injury in the "asphyxiated" infant.
