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06.08.2018 | original article

Nucleated red blood cells and serum lactate values on days 2 and 5 are associated with mortality and morbidity in VLBW infants

Zeitschrift:
Wiener Medizinische Wochenschrift
Autoren:
M.D. Dr. med. Martin Poryo, M.S. Antonia Wissing, Prof. Michael Zemlin, M.S. Aylin Aygün, M.S. Daniel Ebrahimi-Fakhari, Prof. Jürgen Geisel, M.Sc. Jakob Schöpe, Prof. Stefan Wagenpfeil, M.D. Harald Sauer, Prof. Sascha Meyer
Wichtige Hinweise

Authors’ contributions

M.P. was responsible for study design, data analysis, and writing of the manuscript. A.W. was responsible for data compilation and contributed to writing of the manuscript. M.Z. was responsible for data analysis and critical revision of the manuscript. A.A. was responsible for data compilation and contributed to writing of the manuscript. D.E.-F. was responsible for data analysis and critical revision of the manuscript. J.G. was responsible for data acquisition, data analysis, and critical revision of the manuscript. J.S. was responsible for data analysis and editing of the manuscript. S.W. was responsible for data analysis and editing of the manuscript. S.M. was responsible for study design, data collection and analysis, and writing of the manuscript.

Summary

Aim

To correlate nucleated red blood cell counts and serum lactate concentrations on day 2 and 5 of life with morbidity and mortality in very low birth weight infants and to determine corresponding cutoff values.

Methods

Retrospective analysis in a cohort of very low birth weight infants.

Results

250 very low birth weight infants were included in this study. Gestational age ranged from 23 to 35 weeks (mean 29.04) and birth weight was 320–1500 g (mean 1047.9). 55 (22%) patients developed intraventricular hemorrhage, 55 (22%) bronchopulmonary dysplasia, 12 (4.8%) periventricular leukomalacia, 93 (37.2%) retinopathy of prematurity, and 1 (0.4%) necrotizing enterocolitis. Mortality rate was 25/250 (10%). Nucleated red blood cells and serum lactate on day 2 of life were associated with mortality (p < 0.001). Serum lactate on day 5 of life demonstrated an association with retinopathy of prematurity (p = 0.017), bronchopulmonary dysplasia (p = 0.044), and intraventricular hemorrhage (p < 0.001). Cutoff values predicting mortality were >89.5 nucleated red blood cells/100 leucocytes (sensitivity 68.2%, specificity 89.0%) and serum lactate concentrations >8.5 mmol/l (sensitivity 69.6%, specificity 93.5%) on day 2 of life.

Conclusion

We conclude that both nucleated red blood cell count and serum lactate concentration are valuable biomarkers in predicting important outcome parameters in very low birth weight infants.

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