Value of Plasma Lactate Dehydrogenase and Blood Gases Analysis as Predictors of Severity in Neonates with Respiratory Distress Syndrome and Transient Tachypnea of the Newborn

Document Type : Original Article

Authors

1 Department of Pediatrics, Ismailia Medical Complex, Egypt.

2 Department of Pediatrics and Neonatology, Faculty of Medicine - Port Said University, Egypt.

3 Department of Clinical Pathology, Faculty of Medicine - Port Said University, Egypt.

Abstract

Background: Neonatal respiratory distress syndrome (NRDS) and transient tachypnea of the newborn (TTN) are the most common respiratory conditions in neonates, which require early diagnosis for proper management. We aim to investigate Plasma lactate dehydrogenase (LDH) and arterial blood gas as biomarkers for prediction of disease severity and treatment strategies.
Methods: A case-control study was conducted on 75 neonates, divided into three groups: RDS (n = 25), TTN (n = 25), and controls (n = 25). Plasma LDH and ABG parameters were measured. Duration of respiratory support and length of hospital stay, were analyzed. Receiver operating characteristic (ROC) curve analysis was performed to assess the diagnostic performance of LDH and ABG parameters.
Results: The study included 75 neonates divided into RDS, TTN, and control groups. RDS and TTN neonates had lower gestational age, birth weight, and Apgar score compared to controls (p < 0.001). RDS patients had higher respiratory distress grades, longer hospital stay, and extended respiratory support duration (p < 0.001) compared to TTN groups. ABG analysis showed severe acidemia (median pH: 7.3, p < 0.001) and hypoxia (pO2: r: -0.768, p< 0.001) in RDS. LDH levels were significantly elevated in RDS and TTN compared to controls with AUC 1.00 exhibiting 100% sensitivity and 100% specificity at cutoff value equal to 600 IU/ L.
Conclusion: Plasma LDH and ABG parameters in neonates may be reliable predictors of the severity of RDS and TTN. These biomarkers can help for early diagnosis and guiding appropriate clinical decisions toward better neonatal outcomes.

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