Abstract
The effect of hypothermia treatment on white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) values as an indicator of inflammation was evaluated in newborns with hypoxic ischemic encephalopathy (HIE). The study was performed that the before-therapeutic hypothermia (TH) and after-TH WBC, lymphocytes, neutrophils, monocytes and NLR, LMR and PLR values of the complete blood cell count were retrospectively evaluated. The results of the patient group were compared with the results of healthy newborns. A total of 78 patients who underwent TH were evaluated in our study. Mean values before and after TH were NLR3.8/2.7, LMR 5.6/8.6, and PLR 60.3/67.1 respectively. A statistical significance was present for NLR values before and after TH in those with seizure in our study (4.15±2.95/3.01±2.54) but no statistical significance was found for LMR or PLR. In neonates with HIE, effect of TH on complete blood cell count and inflammatory mechanisms (mediated neutrophil and lymphocyte) may be minimal.
Highlights
Hypoxic ischemic encephalopathy (HIE) is still an important problem in Neonatal Intensive Care Units despite advances in its diagnosis and treatment (Shankaran et al, 1991)
white blood cell (WBC), lymphocytes, neutrophils, monocytes, platelets, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) values before and after therapeutic hypothermia (TH) are presented in table III, IV, V
It was found that patients with HIE had high levels of WBC, lymphocyte and neutrophil counts before TH, and these results were lower than those of healthy newborns after TH
Summary
Hypoxic ischemic encephalopathy (HIE) is still an important problem in Neonatal Intensive Care Units despite advances in its diagnosis and treatment (Shankaran et al, 1991). There is ample evidence that therapeutic hypothermia (TH) decreases brain injury caused by asphyxia (DouglasEscobar, Weiss, 2015). Hypothermia decreases the blood-brain barrier damage, release of excitatory neurotransmitters, free radical production, and antiinflammatory cytokine levels (Joy, et al, 2013). Several studies and biochemical markers have been used to detect the extent of multiple organ damage in infants with HIE and to determine its relationship with mortality but no definite conclusion could be reached about the prognosis (Shankaran et al, 1991; Nelson, 2002; Cheong et al, 2012; Douglas-Escobar, Weiss, 2015; Joy et al, 2013). New studies are required to evaluate the factors affecting the HIE diagnosis and early stage prognosis
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