Browsing by discipline "Neonatologia"

Perinatal asphyxia is a main cause of neonatal deaths worldwide. Asphyxia can lead to hypoxic ischemic encephalopathy, which may cause severe neurological impairment to infants. The consequences of hypoxic ischemic encephalopathy can have a significant impact on the life of affected children and their families. Neonates with hypoxic ischemic encephalopathy can be treated with therapeutic hypothermia. Therapeutic hypothermia is to be initiated within 6 hours after birth. Biomarkers of asphyxia used at present are cord blood pH and Apgar score. The severity of hypoxic ischemic encephalopathy is evaluated with the help of clinical assessment, magnetic resonance imaging and amplitude integrated electroencephalography. Currently there is a need for new biomarkers of asphyxia in order to identify adequate candidates for treatment, for the estimation of prognosis and planning of follow up. The purpose of this review is to present and evaluate studies concerning biomarkers of perinatal asphyxia. Biomarkers discussed are erythropoietin, activin a, S-100, nucleated red blood cells, lactate, lactate dehydrogenase, neuron specific enolase, cytokines, free radicals, glial fibrillar acidic protein, copeptin, metabolomics, magnetic resonance techniques (magnetic resonance imaging and magnetic resonance spectroscopy) and neurophysiology (electroencephalography, amplitude integrated electroencephalography and near-infrared spectroscopy. Based on this review, copeptin and glial fibrillary acidic protein may be potential biomarkers. Metabolomics show a new promising field. Further research is, however, required to find new biomarkers that can be validated into clinical use. (226 words)