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Volume 1, No. 1, Jan., 2000
Plasma endothelin-1 concentrations in newborn infants with severe perinatal asphyxia.
Shadia M. El-Sallab1, Amr A. Sarhan1, Ahmed K. Mansour1, Ikbal M. Abu-Hashim2, Hesham E. Abdel-Hady1, Ahmed F. El-Hassanin1
Departments of Pediatrics1 and clinical Pathology2, Mansoura Faculty of Medicine, Mansoura, Egypt.Abstract
Endothelin-1 (ET-1), a potent vasoconstrictor peptide produced by endothelial cells, has been implicated in the development of various organ dysfunctions. To determine the pathophysiologic role of ET-1 in perinatal asphyxia, we assessed the plasma concentrations of ET-1 in 30 severely asphyxiated newborn infants and in 10 healthy newborn infants. Plasma concentrations of ET-1 in the 1st and 5th days of life were significantly higher in asphyxiated infants compared to controls [1.35 (0.64: 1.95)] vs. [0.26 (0.05:0.42)] ng/ml, p< 0.01; and [0.45 (0.22: 0.76)] vs. [0.01(0:0.06) ng/ml, p<0.01, respectively. Plasma ET-1 concentrations were higher in those with stage III compared to those with stage II-hypoxic-ischemic encephalopathy (HIE) ( p<0.001) and in patients with oliguria, intracranial hemorrhage and cardiac affection compared to those without these complications. Moreover, ET-1 concentrations were higher in those who required mechanical ventilation and those who died compared to survivors. Plasma ET-1 concentrations in the 1st day of life correlated negatively with 5-minutes Apgar score, PaO2, corrected creatinine clearance and urine/plasma osmolality and correlated positively with serum creatinine, renal failure index and fractional excretion of sodium. Plasma ET-1 concentrations on the 1st and 5th days of life were found to exert a loading effect towards death in asphyxiated infants. We conclude that plasma ET-1 concentrations can be taken as a marker for hypoxia, ischemia and subsequent organ damage in perinatal asphyxia and may have a prognostic value.
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