Association of Plasma Lactate Dehydrogenase concentration with Oxygen Dependence in Newborn with Respiratory Distress
Abstract
Background: Newborn with respiratory distress may need only supplemental oxygen, whereas in advance stages may require other respiratory supports like HHFNC, CPAP, MV. Respiratory distress in neonates also showed a relationship between LDH levels and the duration of supplying oxygen. Plasma lactate dehydrogenase (LDH) is an indicator of body tissue hypoxia.
Objectives: To find the association of LDH with a duration of oxygen support among newborns with respiratory distress within 24 hours of life.
Methods: This prospective observational study was carried out on 95 neonates, in the Department of Neonatology, BSMMU, Dhaka from July 2021 to June 2022. Enrolled infants were assigned into three groups: RDS group, TTN group, and congenital pneumonia group. LDH collection was done with all aseptic precautions within 24 hours of admission. Different modes of respiratory support were initiated in patients following NICU protocol according to their respiratory severity score. Respiratory supports were titrated according to the infant’s clinical condition, percent saturation of oxygen, and/or arterial blood gas analysis as per NICU protocol. The primary outcome of the study was the duration of oxygen or respiratory support. All data were recorded in a preformed questionnaire and data were analyzed by statistical package for social sciences (SPSS) version 22.0.
Result: A total of 95 neonates were studied, mean values of LDH among the study groups were 755.64±222.70 u/l, 914.68±304.29 u/l and 742.81±284.70 u/l in TTN, RDS, and congenital pneumonia group respectively. High LDH levels were significantly associated with increased need of oxygen supports in study group (P=0.04). In subgroup analysis showed high LDH was significantly associated with increased need of oxygen support in TTN and congenital pneumonia group (P=0.024, P=0.001) respectively. Pearson correlation showed positive correlation between LDH values and duration of oxygen supports (r=0.413, P=001). In this study, high LDH also significantly associated with high respiratory support (p=0.001). There were no statistical association found in high LDH and hospital stay (P=0.165).
Conclusion: High LDH was associated with the increased need of oxygen and advanced respiratory support among the baby with respiratory distress soon after birth. Also, this study showed a strong association of high LDH with the oxygen duration of TTN and the congenital pneumonia group.
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