PubMed · 7796651
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W Li, L Wong. 1995. [Perinatal asphyxia].. https://pubmed.ncbi.nlm.nih.gov/7796651/
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BACKGROUND: Early detection and quantification of brain damage in neonatal asphyxia is important. In adults, S100 protein in blood is associated with damage to the central nervous system. OBJECTIVE: To determine whether S100 protein can be detected in arterial and venous cord blood of healthy newborns and to relate S100 protein concentrations in cord blood to mode of delivery. METHOD: S100 protein levels in umbilical cord blood of 81 healthy infants were determined. RESULTS: S100 protein was present in arterial (median concentration 1.62 micro g/l) and venous (median concentration 1.36 micro g/l) cord blood. Levels were significantly higher in vaginal births (median arterial concentration 1.72 micro g/l; median venous concentration 1.48 micro g/l) than births by caesarean section (1.51 micro g/l and 1.26 micro g/l respectively). CONCLUSION: More research is necessary to determine whether S100 protein is a useful marker in neonatal asphyxia.
In order to test the practicability and safety of whole-body cooling in term neonates with moderate-to-severe hypoxic-ischaemic encephalopathy (HIE) and to report outcomes, a prospective pilot study was carried out in 25 term infants (median postmenstrual age 38 weeks, range 36 to 41 weeks; 20 males, five females). Whole-body cooling, to a target core temperature of 33 to 34 degrees C, started within 6 hours of birth and was maintained for 72 hours. Of the 25 newborn infants (19 Sarnat II and six Sarnat III, 18 outborn), 18 survived, including 13 (72%) with normal cerebral signal by MRI. Temperature instability occurred during cooling in 15 infants, but neither severe haemodynamic instability nor renal failure was seen. Thrombocytopenia developed in 12 infants, including seven with biological disseminated intravascular coagulation. One patient had hypoxaemia with right-to-left shunting through the ductus arteriosus, and seven had limited meningeal or subdural bleeding. Whole-body cooling is feasible in term neonates, with no life-threatening adverse events. Improvements are needed to obtain stable hypothermia for 72 hours.