脐带血乳酸作为围产期窒息诊断和预后的低资源工具的应用尼日利亚南部一家三级医院的经验教训。

IF 1.1 4区 医学 Q2 PEDIATRICS
Chidiebere K Ani, Ikechukwu R Okonkwo, Augustine I Omoigberale
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引用次数: 0

摘要

围产期窒息(PA)是一个全球性的健康问题,与长期发病率和显著死亡率相关。有限的资金和不充分的设施是低收入和中等收入国家(LMICs)的祸根,使得前列腺癌的诊断具有挑战性。寻找一种廉价、简单、特异、敏感的生化参数作为血气分析的替代方法,将有助于改善低收入国家PA的评估。本研究旨在评估脐带动脉血(UCAB)乳酸在足月婴儿PA诊断和预后中的应用。这是一项在UBTH进行的为期7个月的前瞻性横断面分析研究。PA的入选标准为记录在案的危险因素,APGAR评分为5.1 mmol/l,敏感性为89.4%,特异性为90.9%。乳酸UCAB预测新生儿短期不良预后(中重度脑病)的最佳临界值为8.32 mmol/l,敏感性为100%,特异性为94.7%。乳酸UCAB在足月新生儿PA的诊断和短期预后预测方面表现良好。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The utility of cord blood lactate as a low-resource tool in perinatal asphyxia diagnosis and prognosis; lessons from a tertiary hospital in Southern Nigeria.

Perinatal asphyxia (PA) is a global health concern associated with long-term morbidity and significant mortality. Limited finance and inadequate facilities are the bane of the low- and middle-income countries (LMICs) making the diagnosis of PA challenging. The identification of cheap, simple, specific, and sensitive, biochemical parameter as an alternative to blood gas analysis would improve the assessment of PA in LMICs. This study is designed to assess the utility of umbilical cord arterial blood (UCAB) lactate in diagnosis and prognosis of PA among term babies. This was a prospective, cross-sectional analytical study done at UBTH over a 7-month period. The inclusion criteria for PA were documented risk factors, Apearance, Pulse, Grimace, Activity, Respiration (APGAR) score of <7 in 5 minutes, and umbilical cord pH ≤7.25. Samples were collected from the umbilical cord segments of 132 study participants and analysed using Abbott i-STAT. Sixty-six asphyxiated babies were the subjects for this study. The median (interquartile range) UCAB lactate value of the asphyxiated newborns was 7.23 (5.90-9.41) mmol/l which is significantly higher than the apparently healthy newborns of 2.97 (2.27-3.82) mmol/l (U = 4175.50; P < .001). The optimal diagnostic cut-off value of UCAB lactate in the diagnosis of PA was >5.1 mmol/l, with a sensitivity of 89.4% and specificity of 90.9%. The optimal cut-off value of UCAB lactate in predicting short-term adverse neonatal outcome (moderate to severe encephalopathy) was >8.32 mmol/l, having a sensitivity of 100% and specificity of 94.7%. UCAB lactate shows a good performance in the diagnosis of PA and prediction of short-term outcome among term neonates.

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来源期刊
Journal of Tropical Pediatrics
Journal of Tropical Pediatrics 医学-热带医学
CiteScore
4.00
自引率
0.00%
发文量
97
审稿时长
6-12 weeks
期刊介绍: The Journal of Tropical Pediatrics provides a link between theory and practice in the field. Papers report key results of clinical and community research, and considerations of programme development. More general descriptive pieces are included when they have application to work preceeding elsewhere. The journal also presents review articles, book reviews and, occasionally, short monographs and selections of important papers delivered at relevant conferences.
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