Document detail
ID

doi:10.1007/s00467-024-06322-8...

Author
Zhang, Yu Zeng, Huihui
Langue
en
Editor

Springer

Category

Urology

Year

2024

listing date

2/28/2024

Keywords
oliguria asphyxia lactate arterial blood gas acute kidney injury neonates asphyxia elevated 24 h lactate levels pa
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Abstract

Background Oliguria is a sign of impaired kidney function and has been shown to be an early predictor of adverse prognoses in patients with acute kidney injury.

The relationship between urine output (UOP) and early lactate levels in neonates with perinatal asphyxia (PA) has not been extensively explored.

This study aimed to investigate the link between oliguria during the first 24 h of life and early lactate levels in neonates with PA.

Methods The medical records of 293 term neonates with asphyxia from 9216 hospitalized newborns were retrospectively analyzed, including 127 cases designated as the oliguria group and 166 cases as controls.

Peripheral arterial blood gas after PA and UOP within 24 h after birth were analyzed.

Logistic regression analyses and receiver operating characteristic curve analysis were conducted.

Results Oliguria occurred in 43.34% of neonates with PA.

The median UOP of the oliguria and control groups were 0.65 and 1.46 mL/kg/h, respectively.

Elevated lactate levels after PA are an independent risk factor for oliguria in the following 24 h (p = 0.01; OR: 1.19; 95%CI: 1.04–1.35) and show a moderate discriminatory power for oliguria (AUC = 0.62).

Using a cut off value of 8.15 mmol/L, the positive and negative predictive values and the specificity were 59.34%, 63.86%, and 78.30%, respectively.

Conclusion Neonates with elevated lactate levels after PA face a risk of oliguria in the following 24 h. Based on early elevated lactate levels after resuscitation, especially ≥ 8.15 mmol/L, meticulously monitoring UOP will allow this vulnerable population to receive early, tailored fluid management and medical intervention.

Graphical abstract A higher resolution version of the Graphical abstract is available as Supplementary information

Zhang, Yu,Zeng, Huihui, 2024, Initial lactate levels linked to oliguria in term neonates with perinatal asphyxia, Springer

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