The Clinical Analysis Of Acidosis And Mutiple Organ Function Damage In Asphyxial Neonatal

Objective To analysis the clinical datas of arterial blood gas, the amount and degree of every damage organ in asphyxial neonatal, then studied the effects of damage organs in diffrent degree of acidosis, and predicted prognosis.Methods We identified 121 confirmed neonatal asphysial patients in a newborn tertiary center at Shenzhen Children’s Hospital and collected demographic, maternal and newborn history and clinical findings. To evaluate the degree of each damage organ followed the standards of neonatal asphyxia multiple organ damage index. The correlation of pH or BE with damage organs was tested by Spearman correlation analysis. Then we made a statistical analysis of pH, BE, duration of acidosis, damage organs and death cases by using Fisher’s exact probability method or chi-square test.Results Of 121 neonates analyzed, included 78 mild asphysial neonates and 43 severe asphysial neonates. The pH and BE with degree/amout of damage organs and death cases showed a negative correlation, P< 0.001, with statistical significance.1.Different degree of acidosis made different influence on damage organs at the same period. (1)There were 5-6 damage organs, and at least three organs were severe injury with pH< 6.8 and BE≤-25. The brain and lung were damaged most seriously, then were the heart and kidneys. Liver and gastrointestinal were injury in some extent.The mortality of this term reached 100%. (2) With pH> 7.2 and BE>-5, there were 2 mild damage organs at most, and had a good prognosis. (3) When 6.8≤pH<7.0,-25<BE≤-15, there may 4-5 organs were damage. The brain, lung and heart were more serious. The mortality was still high. (4) As 7.0≤pH<7.2,-15<BE≤-5, it showed 3-4 damage organs, but the injury was reversible.2. Different acidosis duration made bad effects on the damage organs (7.0≤pH< 7.35, -+ 15<BE< 3).if acidosis lasted more than 24 hours, the number of injury organ would increase, and the degree of severity rose obviously. The neonates suffered a higher risk of death.Conclusion The more serious is acidosis, the more organs were injury and with greater severity during the same period of asidosis time. When pH less than 6.8 and BE less than or equal to -25, it would suggest a high mortality rate and poor prognosis. While pH in 7.0～7.2 and BE in- 15～-5, it showed less squelae and good prognosis. The organ damage was reversible. For mild to moderate neonatal acidosis, different duration made different effects on damage organs. If acidosis lasted over 24 hours, there would be more severe damage organs with an increased risk of death.