Journal of Developmental Medicine(Electronic Version)  2018, Vol. 6 Issue (3): 172-175 DOI: 10.3969/j.issn.2095-5340.2018.03.008 |
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| The significance of arterial blood gas analysis for neonates with asphyxia after resuscitation |
| GUO Guo, QI Jiao, GUO Yu-ting, ZHANG Xue-feng
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| Department of Neonatology, 302 Military Hospital of China, Beijing 100039, China) |
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Abstract 【Abstract】Objective To investigate the significance of arterial blood gas analysis for neonates with asphyxia after resuscitation. Methods From January 1st, 2012 to December 31st, 2016, 116 cases of neonates with postasphyxial resuscitation, gestational age ≥ 34 weeks, birth weight ≥ 2 500 g, and excluding congenital birth defects and genetic metabolic diseases, were selected from the neonates admitted to the Newborn Clinic of the 302 Military Hospital of China. Arterial blood gas analysis was performed on all subjects. The neonates' gender, gestational age, mode of delivery, blood sampling time, Apgar score at 1, 5, and 10 minutes, and medication for resuscitation were recorded. Independent sample t-test and χ2 test were used for statistical analysis. The sensitivity and specificity of arterial blood pH and base excess (BE) for diagnosis of asphyxia were analyzed using receiver operating characteristic (ROC) curves. Results There were no significant difference in blood sampling time, sex,gestational age, birth weight, cesarean section rate, and forceps delivery rate between mild asphyxia
group and severe asphyxia group (P ﹥ 0.05). None of the neonates in the mild asphyxiation group received medication during the resuscitation. In the severe asphyxiation group, 11 neonates did not use medication, and the rest were treated with epinephrine, 0.9% sodium chloride, sodium bicarbonate naloxone, etc. There were significant difference in pH value (7.352±0.076 vs 7.177±0.032), BE value [(-6.4±4.5) vs (-15.8±6.4) mmol/L], HCO3 － [(18.7±3.6) vs (11.3±4.1) mmol/L] between mild asphyxia group and severe asphyxia group (all P=0.000). The area under the ROC curve of the pH value was 0.842 (P=0.000, 95%CI 0.733-0.950), and that of the BE value was 0.896 (P=0.000 95%CI 0.820-0.972). When pH ≤ 7.27, the sensitivity was 86.0% and the specificity was 75.0%and when BE ≤ -10.6 mmol/L, the sensitivity was 87.2%, the specificity was 83.3%. Meanwhile the Youden index was the largest, and the diagnostic value was the highest. Conclusion Arterial blood gasanalysis of neonates after asphyxial resuscitation is valuable in diagnosing and assessing the degree of
asphyxia and can guide further treatment after resuscitation.
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Received: 20 December 2017
Published: 21 August 2018
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