Biomarkers of hepatic injury and function in neonatal hypoxic ischemic encephalopathy and with therapeutic hypothermia

Muniraman, Hemananda, Gardner, Danielle, Skinner, Jane, Paweletz, Anna, Vayalakkad, Anitha, Chee, Ying Hui, Clifford, Clare, Sanka, Sunil, Venkatesh, Vidheya, Curley, Anna, Victor, Suresh, Turner, Mark A. and Clarke, Paul ORCID: (2017) Biomarkers of hepatic injury and function in neonatal hypoxic ischemic encephalopathy and with therapeutic hypothermia. European Journal of Pediatrics, 176 (10). 1295–1303. ISSN 0340-6199

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Therapeutic hypothermia (TH) is now provided as standard care to infants with moderate-severe hypoxic ischemic encephalopathy (HIE). The role of TH in limiting neuronal injury is well recognized, but its effect on hepatic injury which occurs frequently in neonatal HIE is not known. Our objective was to characterize biomarkers of liver injury and function in the setting of neonatal HIE and to describe whether HIE severity and provision of TH influence these hepatic biomarkers. We performed a multicenter retrospective study and compared hepatic biomarkers obtained during the first postnatal week, according to the severity of HIE and whether treated with TH. Of a total of 361 infants with HIE, 223 (62%) received TH and 138 (38%) were managed at normal temperature. Most hepatic biomarkers and C-reactive protein (CRP) were significantly associated with the severity of HIE (p<0.001). Infants treated with TH had lower peak Alanine aminotransferase (ALT) concentrations (p=0.025) and delay in reaching peak CRP concentration (p<0.001).  Conclusion: We observed a significant association between the clinical grade of HIE and biomarkers of liver metabolism and function. Therapeutic hypothermia was associated with delayed CRP responses and with lower ALT concentrations and so may have the potential to modulate hepatic injury.

Item Type: Article
Additional Information: Erratum available at:
Uncontrolled Keywords: therapeutic hypothermia,liver enzymes,c-reactive protein,perinatal asphyxia,biomarkers
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
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Depositing User: Pure Connector
Date Deposited: 01 Aug 2017 05:08
Last Modified: 19 Apr 2023 22:31
DOI: 10.1007/s00431-017-2956-2

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