Kanimozhi, S (2015) A study to evaluate the significance of serum creatine kinase muscle brai fraction (CK-MB) lactate dehydrogenase (LDH) in neonates with birth asphyxia. Masters thesis, Government Mohan Kumaramangalam Medical College, Salem.
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Abstract
BACKGROUND AND OBJECTIVES: Birth asphyxia is a common neonatal problem and an important cause of neonatal morbidity and mortality. The signs of birth asphyxia injury are so nonspecific and overlap with other illnesses. In the absence of perinatal records it is difficult to diagnose birth asphyxia retrospectively. There is a need to identify birth asphyxiated neonates who are at high risk for developing hypoxic ischemic encephalopathy and multi organ dysfunction in the immediate neonatal period for the purpose of effective management of those asphyxiated neonates to reduce mortality and morbidity. Hence, this study was conducted to evaluate the significance of serum creatine kinase muscle brain fraction (CK-MB) and lactate dehydrogenase (LDH) levels among asphyxiated and non asphyxiated term neonates and to ascertain whether these enzymes can identify asphyxiated newborns. STUDY METHODS: A study was conducted on 50 term newborns included as cases and 50 newborns included as controls meeting the inclusion and exclusion criteria born in Government Mohan Kumaramangalam Medical College & Hospital, Salem from the period of June 2013 to may 2014. Cases are asphyxiated neonates and controls are non – asphyxiated neonates. The blood samples for CK-MB and LDH was drawn at 8±2 hours and 72±2 hours of age respectively and sent for analysis. A serum level of CK-MB > 92.6U/L at 8 hours and LDH >580 U/L at 72 hours was taken as the cut off value. The sensitivity, specificity, predictive value (positive and negative) was calculated for creatine kinase muscle brain fraction and Lactate dehydrogenase. RESULTS: The serum CK-MB value of >92.6U/L has 52% sensitivity with a specificity of 100%. CK-MB has a positive predictive value of 100 % with a negative predictive value of 58.14%. The cut off value of LDH was >580 U/L has 84% sensitivity with a specificity of 100%. Positive predictive value of LDH was 100% with a negative predictive value of 68.94%. LDH is having more diagnostic value than CK-MB with more Area under ROC (receiving operating characteristic) value when compared to CK-MB. INTERPRETATION AND CONCLUSION: From the study the diagnostic performance of LDH is better than CK-MB. Estimation of CK-MB and LDH level at 8 hours and 72 hours of life can distinguish an asphyxiated from a non asphyxiated term newborn in correlation with history and clinical features in the neonate. CK-MB and LDH are the two biochemical markers useful in correlates with severity of HIE.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Hypoxic Ischemic Encephalopathy ; Creatine kinase muscle-brain fraction ; lactate dehydrogenase ; perinatal asphyxia ; newborn. |
| Subjects: | MEDICAL > Paediatrics |
| Depositing User: | Punitha K |
| Date Deposited: | 21 Jun 2018 14:22 |
| Last Modified: | 06 Aug 2018 08:35 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/8545 |
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