van der Heide, Martin;
Muller Kobold, Anneke C;
Koerts-Steijn, Karin KR;
Hulzebos, Christian V;
Hulscher, Jan BF;
Eaton, Simon;
Orford, Michael;
... Kooi, Elisabeth MW; + view all
(2024)
Ischemia modified albumin as a marker of hypoxia in preterm infants in the first week after birth.
Early Human Development
, 189
, Article 105927. 10.1016/j.earlhumdev.2023.105927.
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Ischemia modified albumin as a marker of hypoxia in preterm infants in the first week after birth 2023-06-12.pdf - Accepted Version Download (406kB) | Preview |
Abstract
Background: Tissue hypoxia remains a leading cause of morbidity and mortality in preterm infants. Current biomarkers often detect irreversible hypoxic cellular injury (i.e. lactate) and are non-specific. A new biomarker is needed which detects tissue hypoxia before irreversible damage occurs. Aims: To investigate the relation between serum ischemia modified albumin (IMA), a marker of hypoxia; and analytic variables, patient related variables and conditions associated with hypoxia, in preterm infants. Study design: Retrospective cohort study. Subjects: Infants with a gestational age < 30 weeks and/or birth weight < 1000 g. Outcome measures: We collected two remnant blood samples in the first week after birth and measured IMA. IMA/albumin ratio (IMAR) was used to adjust for albumin. We assessed correlations between IMA(R) and analytic variables (albumin, lipemia- and haemolysis index); mean-2 h SpO2; mean-2 h variability of regional splanchnic oxygen saturation (rsSO2), measured using near-infrared spectroscopy; and patent ductus arteriosus (PDA). Results: Sixty-five infants were included. Albumin, the lipemia- and haemolysis index correlated negatively with IMA (r:-0.620, P<0.001; r:-0.458, P<0.001; and r:-0.337, P=0.002). IMAR correlated negatively with SpO2 (rho:-0.614, P<0.001). Lower rsSO2 variability correlated with higher IMAR values (rho:-0.785, n=14, P=0.001 and rho:-0.773, n=11, P=0.005). Infants with a hemodynamic significant PDA (hsPDA) had higher IMAR values than infants without PDA (0.13 [0.11–0.28], n=16 vs. 0.11 [0.08–0.20], n=29, P=0.005 and 0.11 [0.09–0.18], n=13 vs. 0.09 [0.06–0.17], n=37, P=0.026). Conclusions: When adjusted for albumin, the lipemia- and haemolysis index, IMAR has potential value as a marker for systemic hypoxia in preterm infants, considering the associations with SpO2, variability of rsSO2, and hsPDA.
| Type: | Article |
|---|---|
| Title: | Ischemia modified albumin as a marker of hypoxia in preterm infants in the first week after birth |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.earlhumdev.2023.105927 |
| Publisher version: | http://dx.doi.org/10.1016/j.earlhumdev.2023.105927 |
| Language: | English |
| Additional information: | This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. |
| Keywords: | Hypoxia, Ischemia modified albumin, Necrotizing enterocolitis, Patent ductus arteriosus, Preterm infants |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Biology and Cancer Dept |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/10185124 |
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