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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Greaves, Ronda / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter


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Volume 57, Issue 7

Issues

Monitoring the effectiveness of hypothermia in perinatal asphyxia infants by urinary S100B levels

Iliana Bersani
  • Department of Medical and Surgical Neonatology, Bambino Gesù Children’s Hospital, Rome, Italy
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/ Fabrizio Ferrari
  • Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy
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/ Licia Lugli
  • Division of Neonatal Intensive Care Unit, Department of Pediatrics, University Hospital, Modena, Italy
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/ Giorgio Ivani / Alessandra Conio / Bashir Moataza / Hanna Aboulgar / Hala Mufeed / Iman Iskander / Maria Kornacka / Darek Gruzfeld / Andrea Dotta
  • Department of Medical and Surgical Neonatology, Bambino Gesù Children’s Hospital, Rome, Italy
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/ Immacolata Savarese
  • Department of Medical and Surgical Neonatology, Bambino Gesù Children’s Hospital, Rome, Italy
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/ Natalia Chukhlantseva
  • Department of Medical and Surgical Neonatology, Bambino Gesù Children’s Hospital, Rome, Italy
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/ Lucia Gabriella Tina / Francesco Nigro / Giovanni Livolti / Fabio Galvano / Laura Serpero
  • Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children’s Hospital, Alessandria, Italy
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/ Micaela Colivicchi
  • Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children’s Hospital, Alessandria, Italy
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/ Patrizia Ianniello
  • Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children’s Hospital, Alessandria, Italy
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/ Francesca Pluchinotta
  • Department of Cardiology and Laboratory Research, S. Donato Milanese University Hospital, Milan, Italy
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/ Luigi Anastasia
  • Department of Cardiology and Laboratory Research, S. Donato Milanese University Hospital, Milan, Italy
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/ Ekaterina Baryshnikova
  • Department of Cardiology and Laboratory Research, S. Donato Milanese University Hospital, Milan, Italy
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/ Diego Gazzolo
  • Corresponding author
  • Department of Maternal, Fetal and Neonatal Medicine, C. Arrigo Children’s Hospital, Alessandria, Italy
  • Neonatal Intensive Care Unit, G. d’Annunzio University, Chieti, Italy
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Published Online: 2019-02-12 | DOI: https://doi.org/10.1515/cclm-2018-1094

Abstract

Background

Perinatal asphyxia is a major cause of mortality and morbidity in neonates: The aim of the present study was to investigate, by means of longitudinal assessment of urinary S100B, the effectiveness of hypothermia, in infants complicated by perinatal asphyxia and hypoxic-ischemic encephalopathy.

Methods

We performed a retrospective case-control study in 108 asphyxiated infants, admitted to nine tertiary departments for neonatal intensive care from January 2004 to July 2017, of whom 54 underwent hypothermia treatment and 54 did not. The concentrations of S100B protein in urine were measured using an immunoluminometric assay at first urination and 4, 8, 12, 16, 20, 24, 48, 72, 96, 108 and 120 h after birth. The results were correlated with the achievement of S100B levels within normal ranges at 72 h from hypothermia treatment. Routine laboratory parameters, longitudinal cerebral function monitoring, cerebral ultrasound and neurologic patterns were assessed according to standard protocols.

Results

Higher S100B concentrations were found in hypothermia-treated infants in both moderate (up to 12 h) and severe (up to 24 h) hypoxic-ischemic encephalopathy. S100B levels returned to normal ranges starting from 20 h of hypothermia treatment in moderate and from 36 h in severe hypoxic-ischemic encephalopathy.

Conclusions

The present results offer additional support to the usefulness of longitudinal neuro-biomarkers monitoring in asphyxiated infants treated by hypothermia. The pattern of S100B concentrations during hypothermia supports the need for further investigations aimed at reconsidering the time-window for patient recruitment and treatment, and the optimal duration of the cooling and rewarming phases of the hypothermia procedure.

Keywords: asphyxia; hypothermia; neonate; S100B

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About the article

Corresponding author: Prof. Diego Gazzolo, Department of Maternal, Fetal and Neonatal Health C. Arrigo Children’s Hospital, Alessandria, Italy; and Neonatal Intensive Care Unit, G. d’Annunzio University, Chieti, Italy


Received: 2018-10-09

Accepted: 2019-01-18

Published Online: 2019-02-12

Published in Print: 2019-06-26


Author contribution: Bersani Iliana and Serpero Laura contributed to the conceptualization, investigation and writing – original draft. Ferrari Fabrizio contributed to the conceptualization, investigation and writing – review and editing. Conio Alessandra, Gruszfeld Darek, Savarese Immacolata, Iskander Iman, Tina Lucia Gabriella, Nigro Francesco, Ianniello Patrizia, Baryshnikova Ekaterina and Natalia Chukhlantseva contributed to the investigation. Aboulgar Hanna, Bashir Moataza, Mufeed Said Hala, Kornacka Maria, Ivani Giorgio, Lugli Licia, Andrea Dotta, Livolti Giovanni, Galvano Fabio, Colivicchi Micaela and Pluchinotta Francesca contributed to the investigation and conceptualization. Anastasia Luigi contributed to the conceptualization and supervision. Diego Gazzolo contributed to the project administration, conceptualization, investigation, supervision and writing – review and editing. All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: This work is part of the I.O. PhD International Program under the auspices of the Italian Society of Neonatology and was partially supported by grants to DG from “I Colori della Vita Foundation”, Italy. We thank Diasorin, Saluggia, Italy, for supporting analysis kits.

Employement or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organizations played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.


Citation Information: Clinical Chemistry and Laboratory Medicine (CCLM), Volume 57, Issue 7, Pages 1017–1025, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/cclm-2018-1094.

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