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Erschienen in: Wiener Medizinische Wochenschrift 3-4/2019

06.08.2018 | original article

Nucleated red blood cells and serum lactate values on days 2 and 5 are associated with mortality and morbidity in VLBW infants

verfasst von: M.D. Dr. med. Martin Poryo, M.S. Antonia Wissing, Prof. Michael Zemlin, M.S. Aylin Aygün, M.S. Daniel Ebrahimi-Fakhari, Prof. Jürgen Geisel, M.Sc. Jakob Schöpe, Prof. Stefan Wagenpfeil, M.D. Harald Sauer, Prof. Sascha Meyer

Erschienen in: Wiener Medizinische Wochenschrift | Ausgabe 3-4/2019

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Summary

Aim

To correlate nucleated red blood cell counts and serum lactate concentrations on day 2 and 5 of life with morbidity and mortality in very low birth weight infants and to determine corresponding cutoff values.

Methods

Retrospective analysis in a cohort of very low birth weight infants.

Results

250 very low birth weight infants were included in this study. Gestational age ranged from 23 to 35 weeks (mean 29.04) and birth weight was 320–1500 g (mean 1047.9). 55 (22%) patients developed intraventricular hemorrhage, 55 (22%) bronchopulmonary dysplasia, 12 (4.8%) periventricular leukomalacia, 93 (37.2%) retinopathy of prematurity, and 1 (0.4%) necrotizing enterocolitis. Mortality rate was 25/250 (10%). Nucleated red blood cells and serum lactate on day 2 of life were associated with mortality (p < 0.001). Serum lactate on day 5 of life demonstrated an association with retinopathy of prematurity (p = 0.017), bronchopulmonary dysplasia (p = 0.044), and intraventricular hemorrhage (p < 0.001). Cutoff values predicting mortality were >89.5 nucleated red blood cells/100 leucocytes (sensitivity 68.2%, specificity 89.0%) and serum lactate concentrations >8.5 mmol/l (sensitivity 69.6%, specificity 93.5%) on day 2 of life.

Conclusion

We conclude that both nucleated red blood cell count and serum lactate concentration are valuable biomarkers in predicting important outcome parameters in very low birth weight infants.
Literatur
1.
Zurück zum Zitat Cremer M, Roll S, Gräf C, Weimann A, Bührer C, Dame C. Nucleated red blood cells as marker for an increased risk of unfavorable outcome and mortality in very low birth weight infants. Early Hum Dev. 2015;91:559–63. CrossRef Cremer M, Roll S, Gräf C, Weimann A, Bührer C, Dame C. Nucleated red blood cells as marker for an increased risk of unfavorable outcome and mortality in very low birth weight infants. Early Hum Dev. 2015;91:559–63. CrossRef
2.
Zurück zum Zitat Perrone S. Nucleated red blood cell count in term and preterm newborns: reference values at birth. Arch Dis Child Fetal Neonatal Ed. 2005;90:F174–F5. CrossRef Perrone S. Nucleated red blood cell count in term and preterm newborns: reference values at birth. Arch Dis Child Fetal Neonatal Ed. 2005;90:F174–F5. CrossRef
3.
Zurück zum Zitat Christensen RD, Henry E, Andres RL, Bennett ST. Reference ranges for blood concentrations of nucleated red blood cells in neonates. Neonatology. 2011;99:289–94. CrossRef Christensen RD, Henry E, Andres RL, Bennett ST. Reference ranges for blood concentrations of nucleated red blood cells in neonates. Neonatology. 2011;99:289–94. CrossRef
4.
Zurück zum Zitat Ghosh B, Mittal S, Kumar S, Dadhwal V. Prediction of perinatal asphyxia with nucleated red blood cells in cord blood of newborns. Int J Gynecol Obstet. 2003;81:267–71. CrossRef Ghosh B, Mittal S, Kumar S, Dadhwal V. Prediction of perinatal asphyxia with nucleated red blood cells in cord blood of newborns. Int J Gynecol Obstet. 2003;81:267–71. CrossRef
5.
Zurück zum Zitat Ferber A, Fridel Z, Weissmann-Brenner A, Minior VK, Divon MY. Are elevated fetal nucleated red blood cell counts an indirect reflection of enhanced erythropoietin activity? Am J Obstet Gynecol. 2004;190:1473–5. CrossRef Ferber A, Fridel Z, Weissmann-Brenner A, Minior VK, Divon MY. Are elevated fetal nucleated red blood cell counts an indirect reflection of enhanced erythropoietin activity? Am J Obstet Gynecol. 2004;190:1473–5. CrossRef
6.
Zurück zum Zitat Baschat AA, Gungor S, Kush ML, Berg C, Gembruch U, Harman CR. Nucleated red blood cell counts in the first week of life: a critical appraisal of relationships with perinatal outcome in preterm growth-restricted neonates. Am J Obstet Gynecol. 2007;197:1–8. CrossRef Baschat AA, Gungor S, Kush ML, Berg C, Gembruch U, Harman CR. Nucleated red blood cell counts in the first week of life: a critical appraisal of relationships with perinatal outcome in preterm growth-restricted neonates. Am J Obstet Gynecol. 2007;197:1–8. CrossRef
7.
Zurück zum Zitat Walsh B, Boylan G, Dempsey E, Murray D. Association of nucleated red blood cells and severity of encephalopathy in normothermic and hypothermic infants. Acta Paediatr. 2013;102:e64–e7. CrossRef Walsh B, Boylan G, Dempsey E, Murray D. Association of nucleated red blood cells and severity of encephalopathy in normothermic and hypothermic infants. Acta Paediatr. 2013;102:e64–e7. CrossRef
8.
Zurück zum Zitat Shah S, Tracy M, Smyth J. Postnatal lactate as an early predictor of short-term outcome after intrapartum asphyxia. J Perinatol. 2004;24:16–20. CrossRef Shah S, Tracy M, Smyth J. Postnatal lactate as an early predictor of short-term outcome after intrapartum asphyxia. J Perinatol. 2004;24:16–20. CrossRef
9.
Zurück zum Zitat Nadeem M, Clarke A, Dempsey EM. Day 1 serum lactate values in preterm infants less than 32 weeks gestation. Eur J Pediatr. 2010;169:667–70. CrossRef Nadeem M, Clarke A, Dempsey EM. Day 1 serum lactate values in preterm infants less than 32 weeks gestation. Eur J Pediatr. 2010;169:667–70. CrossRef
10.
Zurück zum Zitat Hawdon JM, Platt MPW, Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child. 1992;67:357–65. CrossRef Hawdon JM, Platt MPW, Aynsley-Green A. Patterns of metabolic adaptation for preterm and term infants in the first neonatal week. Arch Dis Child. 1992;67:357–65. CrossRef
11.
Zurück zum Zitat Cousineau J, Anctil S, Carceller A, Gonthier M, Delvin EE. Neonate capillary blood gas reference values. Clin Biochem. 2005;38:905–7. CrossRef Cousineau J, Anctil S, Carceller A, Gonthier M, Delvin EE. Neonate capillary blood gas reference values. Clin Biochem. 2005;38:905–7. CrossRef
12.
Zurück zum Zitat Poryo M, Wissing A, Aygün A, Geisel J, Wagenpfeil S, Zemlin M, Meyer S. Reference values for nucleated red blood cells and serum lactate in very and extremely low birth weight infants in the first week of life. Early Hum Dev. 2017;105:49–55. CrossRef Poryo M, Wissing A, Aygün A, Geisel J, Wagenpfeil S, Zemlin M, Meyer S. Reference values for nucleated red blood cells and serum lactate in very and extremely low birth weight infants in the first week of life. Early Hum Dev. 2017;105:49–55. CrossRef
13.
Zurück zum Zitat Unterscheider J, Daly S, Geary MP, Kennelly MM, McAuliffe FM, O’Donoghue K, Hunter A, Morrison JJ, Burke G, Dicker P, Tully EC, Malone FD. Optimizing the definition of intrauterine growth restriction: The multicenter prospective PORTO Study. Am J Obstet Gynecol. 2013;208(290):e1–290.e6. Unterscheider J, Daly S, Geary MP, Kennelly MM, McAuliffe FM, O’Donoghue K, Hunter A, Morrison JJ, Burke G, Dicker P, Tully EC, Malone FD. Optimizing the definition of intrauterine growth restriction: The multicenter prospective PORTO Study. Am J Obstet Gynecol. 2013;208(290):e1–290.e6.
14.
Zurück zum Zitat Voigt M, Rochow N, Schneider KTM, Hagenah HP, Straube S, Scholz R, Hesse V, Hentschel R, Olbertz D. Neue Perzentilwerte für die Körpermaße neugeborener Einlinge: Ergebnisse der deutschen Perinatalerhebung der Jahre 2007–2011 unter Beteiligung aller 16 Bundesländer. Z Geburtshilfe Neonatol. 2014;218:210–7. CrossRef Voigt M, Rochow N, Schneider KTM, Hagenah HP, Straube S, Scholz R, Hesse V, Hentschel R, Olbertz D. Neue Perzentilwerte für die Körpermaße neugeborener Einlinge: Ergebnisse der deutschen Perinatalerhebung der Jahre 2007–2011 unter Beteiligung aller 16 Bundesländer. Z Geburtshilfe Neonatol. 2014;218:210–7. CrossRef
15.
Zurück zum Zitat Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T. Neonatal Necrotizing Enterocolitis. Ann Surg. 1978;187:1–7. CrossRef Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, Barton L, Brotherton T. Neonatal Necrotizing Enterocolitis. Ann Surg. 1978;187:1–7. CrossRef
16.
Zurück zum Zitat Jobe AH, Bancalari E. Bronchopulmonary Dysplasia. Am J Respir Crit Care Med. 2001;163:1723–9. CrossRef Jobe AH, Bancalari E. Bronchopulmonary Dysplasia. Am J Respir Crit Care Med. 2001;163:1723–9. CrossRef
17.
Zurück zum Zitat Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92:529–34. CrossRef Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr. 1978;92:529–34. CrossRef
20.
Zurück zum Zitat Groenendaal F, Lindemans C, Uiterwaal CSPM, De Vries LS. Early arterial lactate and prediction of outcome in preterm neonates admitted to a neonatal intensive care unit. Biol Neonate. 2003;83:171–6. CrossRef Groenendaal F, Lindemans C, Uiterwaal CSPM, De Vries LS. Early arterial lactate and prediction of outcome in preterm neonates admitted to a neonatal intensive care unit. Biol Neonate. 2003;83:171–6. CrossRef
21.
Zurück zum Zitat Phillips LA, Dewhurst CJ, Yoxall CW. The prognostic value of initial blood lactate concentration measurements in very low birthweight infants and their use in development of a new disease severity scoring system. Arch Dis Child Fetal Neonatal Ed. 2011;96:F275–80. CrossRef Phillips LA, Dewhurst CJ, Yoxall CW. The prognostic value of initial blood lactate concentration measurements in very low birthweight infants and their use in development of a new disease severity scoring system. Arch Dis Child Fetal Neonatal Ed. 2011;96:F275–80. CrossRef
22.
Zurück zum Zitat Cheung PY, Chui N, Joffe AR, Rebeyka IM, Robertson CMT, Casiro O, Dyck JD, Harder JR, Sauve RS, Reid W, Blakley P. Postoperative lactate concentrations predict the outcome of infants aged 6 weeks or less after intracardiac surgery: A cohort follow-up to 18 months. J Thorac Cardiovasc Surg. 2005;130:837–43. CrossRef Cheung PY, Chui N, Joffe AR, Rebeyka IM, Robertson CMT, Casiro O, Dyck JD, Harder JR, Sauve RS, Reid W, Blakley P. Postoperative lactate concentrations predict the outcome of infants aged 6 weeks or less after intracardiac surgery: A cohort follow-up to 18 months. J Thorac Cardiovasc Surg. 2005;130:837–43. CrossRef
23.
Zurück zum Zitat Cheung PY, Etches PC, Weardon M, Reynolds A, Finer NN, Robertson CM. Use of plasma lactate to predict early mortality and adverse outcome after neonatal extracorporeal membrane oxygenation: a prospective cohort in early childhood. Crit Care Med. 2002;30:2135–9. CrossRef Cheung PY, Etches PC, Weardon M, Reynolds A, Finer NN, Robertson CM. Use of plasma lactate to predict early mortality and adverse outcome after neonatal extracorporeal membrane oxygenation: a prospective cohort in early childhood. Crit Care Med. 2002;30:2135–9. CrossRef
24.
Zurück zum Zitat Hussain F, Gilshenan K, Gray PH. Does lactate level in the first 12 hours of life predict mortality in extremely premature infants? J Paediatr Child Health. 2009;45:263–7. CrossRef Hussain F, Gilshenan K, Gray PH. Does lactate level in the first 12 hours of life predict mortality in extremely premature infants? J Paediatr Child Health. 2009;45:263–7. CrossRef
25.
Zurück zum Zitat Haiju Z, Suyuan H, Xiufang F, Lu Y, Sun R. The combined detection of umbilical cord nucleated red blood cells and lactate: Early prediction of neonatal hypoxic ischemic encephalopathy. J Perinat Med. 2008;36:240–7. CrossRef Haiju Z, Suyuan H, Xiufang F, Lu Y, Sun R. The combined detection of umbilical cord nucleated red blood cells and lactate: Early prediction of neonatal hypoxic ischemic encephalopathy. J Perinat Med. 2008;36:240–7. CrossRef
Metadaten
Titel
Nucleated red blood cells and serum lactate values on days 2 and 5 are associated with mortality and morbidity in VLBW infants
verfasst von
M.D. Dr. med. Martin Poryo
M.S. Antonia Wissing
Prof. Michael Zemlin
M.S. Aylin Aygün
M.S. Daniel Ebrahimi-Fakhari
Prof. Jürgen Geisel
M.Sc. Jakob Schöpe
Prof. Stefan Wagenpfeil
M.D. Harald Sauer
Prof. Sascha Meyer
Publikationsdatum
06.08.2018
Verlag
Springer Vienna
Erschienen in
Wiener Medizinische Wochenschrift / Ausgabe 3-4/2019
Print ISSN: 0043-5341
Elektronische ISSN: 1563-258X
DOI
https://doi.org/10.1007/s10354-018-0649-8

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