The impact of therapeutic hypothermia on peripheral blood cell in newborns with hypoxic ischemic encephalopathy

Abstract The effect of hypothermia treatment on white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values as an indicator of inflammation was evaluated in newborns with hypoxic ischemic encephalopathy (HIE). The study was performed that the before-therapeutic hypothermia (TH) and after-TH WBC, lymphocytes, neutrophils, monocytes and NLR, LMR and PLR values of the complete blood cell count were retrospectively evaluated. The results of the patient group were compared with the results of healthy newborns. A total of 78 patients who underwent TH were evaluated in our study. Mean values before and after TH were NLR3.8/2.7, LMR 5.6/8.6, and PLR 60.3/67.1 respectively. A statistical significance was present for NLR values before and after TH in those with seizure in our study (4.15±2.95/3.01±2.54) but no statistical significance was found for LMR or PLR. In neonates with HIE, effect of TH on complete blood cell count and inflammatory mechanisms (mediated neutrophil and lymphocyte) may be minimal.

Predictive Value of Vasoactive-inotropic Score for Mortality in Newborns Undergoing Cardiac Surgery

Objective: Vasoactive-inotropic Score (VIS) was developed to quantify the amount ofinotropic support provided in the postoperative period. We investigated the predictive value of(VIS) for mortality in neonates with congenital heart disease (CHD). Study design:Prospective cohort. Patients: 119 newborns who underwent cardiac surgery. Setting:Tertiary NICU-CHD center of Ankara from November 2016 to January 2019. Intervention/Measurement: VIS values were calculated by a standard formula for the first 72postoperative hours, and the maximum score was recorded. Primary outcomes: Duration ofmechanical ventilation, NICU length of stay, and mortality. Results: At surgery, the median(IQR) age was 15 d (9-31). The patients were divided into two groups according to mortality;Group 1 (Non-survivors) (n=36) and Group 2 (Survivors) (n=83). Higher VIS score wascorrelated to longer duration of mechanical ventilation (P=0.009, r=0.33), and was higheramong patients who died (P=0.003). Area under the curve (AUC) was 0,83 (P<0.001, CI: 95%0.7-0.9) for VIS to identify mortality. At a cut-off value of 15.5, sensitivity and negativepredictive values of VIS for mortality were 73.6% and 85.3%, respectively. The higher VIS(>15.5) was independently associated with increased odds for mortality (OR: 8.1, 95% CI:1.8-35.7, P=0.005). Conclusions: In newborns with CHD, a higher VIS within 72 hours aftercardiac surgery is associated with increased duration of mechanical ventilation, and mortality.VIS may be useful for prediction of mortality at early postoperative period.