Serum protein S-100 and serum ionized calcium as early prognostic markers for the severity of hypoxic - ischemic encephalopathy after birth asphyxia

This study was performed at Al Ansar Hospital in Jeddah during the period from September 2004 to September 2005. Our objective was to identify whether moderate or severe hypoxic-ischemic encephalopathy [HIE] after birth asphyxia can be predicted by measuring serum protein S-100 or serum ionized calcium concentrations soon after birth. The study included two groups, asphyxia group and control group. The asphyxiated group included 21 full term asphyxiated newborn infants, who were subdivided clinically into: 10 asphyxiated newborns with no HIE, 5 asphyxiated newborns with mild HIE, 3 asphyxiated newborns with moderate HIE, and 3 newborns with severe HIE. The control group included 10 full term healthy normal newborn infants. Neurological examinations were performed during the first 3 days after birth, and Apgar score was estimated at 1 and 5 min after birth. Blood samples were collected from cord blood and 4 h after birth to estimate serum protein S-100, serum ionized calcium, pH, and base deficit. At 4 h after birth, there was a significant increase in serum protein S-100 and a significant decrease in serum ionized calcium in asphyxiated newborns compared with controls, and also a significant difference between asphyxiated newborns with moderate or severe HIE and asphyxiated newborns with no or mild HIE. Both markers had a high positive predictive value and a high specificity, which in case of serum protein S-100 became more higher when combined with serum ionized calcium, cord blood pH, cord blood base deficit, and Apgar score at 1 min. We concluded that serum protein S-100 and serum ionized calcium are early markers for moderate or severe HIE after asphyxia, which help us to initiate and continue or stop the neuroprotective therapy. We concluded also that these markers are of high positive predictive value and of high specificity

Gases Arteriales en Pacientes Normales Mayores de 50 Anos / Arterial Blood Gases in Normal Patients over 50 Years Old

Se realizo un estudio clinico y paraclinico de tipo prospectivo analitico y evaluativo, tomando un total de cien personas mayores de 50 anos sin patologia subyacente a quienes se distribuyeron en 5 grupos iguales (n=20) de 10 en 10 anos. Se les tomaron muestras de sangre arterial para analizar 14 variables que evaluaron las condiciones de oxigenacion (PaO2, saturacion arterial de O2, PAO2, DAaO2, relacion PaO2/FiO2, relacion PaO2/PAO2, relacion DAaO2/PaO2, CaO2), ventilacion (PaCO2) y equilibrio acido base (pH, HCO3 B.E.) correlacionanadolas con la edad y el sexo, para observar su comportamiento con el transcurrir de la edad. Para una presion barometrica de 586 mm Hg encontro una Pa O2 media para el grupo total de 63.82 mm Hg,con variaciones progresivas de disminucion para cada ano de edad de 0.131,lo cual permitio presentar una formula de prediccion para la PaO2 esperada para una edad dada (Pa O2 esperada = 73.53 - (0.131 * edad en anos)a partir de los 50 anos; la correlacion con los pacientes menores de 50 anos para el primer grupo, 50-59 anos, mostro significancia estadistica (< 50 = 70.69, 50-69 anos = 66.52mm Hg). La PaCO2 presento un aumento de significacion estadistica (p => 0.05) para los grupos de 60 a 69 y de mas de 90 anos, sin correlacion dada por el coeficiente de regresion, pero con cifras menores de 35 mm Hg. Las demas variables de oxigenacion siguieron el comportamiento de la PaO2 excepcion hecha del continido de O2, el cual depende de la Hb, mas que de la PaO2. Las variables de equilibrio acido basico tampoco mostraron variaciones de los grupo..