PS-114Prognostic Performance Of Proton Magnetic Resonance Spectroscopy (hmrs) Metabolite Ratios In The First 96 Hours Of Life In Asphyxiated Neonates

• Published in: Archives of disease in childhood Vol. 99; no. Suppl 2; p. A151
• Main Authors: Barta, H, Jermendy, A, Kolossvary, M, Rudas, G, Szabo, M
• Format: Journal Article
• Language: English
• Published: 01.10.2014
• ISSN: 0003-9888
• DOI: 10.1136/archdischild-2014-307384.408

Background and aimsNeonatal hypoxic-ischaemic encephalopathy (HIE) can lead to neurodevelopmental impairment, raising a need for early prognostic tools to guide therapy. The prognostic value of HMRS performed between 5-30 days of life has been extensively studied, although few studies focus on earlier periods. Therefore, we investigated the prognostic performance of HMRS during the first 96 h of life.Methods55 consecutive hypothermia-treated HIE neonates were examined by HMRS at three echo-times (TE = 35 ms, 144 ms, 288 ms) between 6-96 h of age, depending of clinical stability. Patients were divided into favourable (n = 38) and unfavourable (n = 17) outcome groups based on Bayley II MDI and PDI scores ( greater than or equal to 70 vs <70 or death, respectively) assessed at 18-26 months of age. Associations between 36 routinely measured metabolite ratios (MROs) and outcome were studied. The prognostic performance of MROs was evaluated by ROC analysis. Time-dependent changes of MROs in whole patient population were also assessed.Results6 MROs showed significant difference between outcome groups after correction for multiple testing (p < 0.0014). ROC analysis revealed that Myo-inositol/N-Acetyl-Aspartate (TE = 35) gives best prediction for outcome with 85.71% sensitivity and 91.30% specificity. Assessment of time-dependency showed that 4 of 6 MROs stay constant during the first 96 h of life, all containing Myo-inositol.ConclusionsOur findings suggest that during the first 96 h of life HMRS could be a useful early prognostic tool in predicting the outcome of asphyxiated neonates. Myo-inositol/N-Acetyl-Aspartate ratio was found to be the best and time-independent predictor.