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May 1989

Acute Systemic Organ Injury in Term Infants After Asphyxia

Author Affiliations

From the Edward Mallinckrodt Department of Pediatrics, Divisions of Newborn Medicine (Dr Perlman and Dr Tack) and Cardiology (Dr Martin), Edward Mallinckrodt Department of Radiology (Dr Shackelford), and the Department of Obstetrics/Gynecology (Dr Amon), Washington University School of Medicine, St Louis, Mo.

Am J Dis Child. 1989;143(5):617-620. doi:10.1001/archpedi.1989.02150170119037

• The systemic manifestations of "asphyxia" were evaluated prospectively in 35 consecutively intubated term newborn infants. The following systemic organ injuries were identified most often: (1) renal, ie, oliguria less than 1 mL/kg per hour for at least 24 hours (40%), an elevated urinary β-2-microglobulin concentration (57%), azotemia (11%), and an elevated serum creatinine level (17%); (2) central nervous system, ie, hypoxic-ischemic encephalopathy (including seizures) (31%) or an abnormal cranial ultrasound scan, ie, diffuse parenchymal echogenicity, slitlike ventricles, and poor visualization of the sulci, and/or intracranial hemorrhage (26%); (3) cardiovascular, ie, an abnormal echocardiogram (25%) or abnormal electrocardiogram (11%); (4) pulmonary complications, including persistent pulmonary hypertension (23%); and (5) gastrointestinal complications, which were rare. Traditional markers of fetal distress were not related to the frequency and/or distribution of systemic organ injury. An important implication of this study relates to the recognition of the extent and distribution of organ injury in the "asphyxiated" infant.

(AJDC. 1989;143:617-620)

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