Measuring Serum Level of Total L Carnitine in HIE and TTN
Condition: Compare Between the Serum Level of Lcarnitine in HIE Cases and TTN
Study type: Observational

Summary: 
      It is a comparative prospective and observational study conducted at Neonatal Intensive Care
      Unit (NICU) in Assiut University Children Hospital. All cases of perinatal asphyxia and TTN
      admitted to the NICU during the period 12-2016 to 6-2018 were included. All the included
      newborns were examined and the serum level of total L carnitine was measured. Then we
      compared the demographic data and investigation of cases with HIE with the outcome of those
      cases. Results: It was found that serum level of total L carnitine decreased in both HIE and
      TTN cases but without significant difference with mean 5.51 ± 1.30 umol/l in group I vs 6.22
      ± 2.56 umol/l in group II. The male factor with changes in the serum sodium (132.63 ± 9.30)
      and abnormal serum creatinine level [1.4 (0.7-15.0)] were significantly related to the
      outcome of cases with HIE
    

Detailed description: 
      This is a prospective comparative and observational study included all the full-term HIE and
      TTN cases admitted to NICU of the University Children Hospital during the period of December
      2016 to June 2018. The newborns with perinatal asphyxia who died before admission,
      gestational age<37wks and those with congenital anomalies were excluded. The study included
      35 HIE Patients and 12 TTN patients. All cases were subjected to full perinatal history and
      clinical examination. HIE cases were classified clinically by Sarnat staging (Sarnat and
      Sarnat, 1976) [10]. HIE cases were subjected to investigations as capillary blood gases,
      complete blood count (CBC), and electrolytes, renal function. The demographic data and the
      results of HIE investigations will be correlated to the outcome. The serum level of total L
      carnitine was measured for both HIE and TTN cases by sending 1 ml of newborn serum frozen to
      be analyzed by human ELIZA (Enzyme Linked Immunosorbent Assay) kit (SinoGeneClon Biotech
      Co.,Ltd) within the 1st week of life and compared with each other. Normal range in males and
      females 17.4-58.7umol/l. the

      Statistical analysis:

      Data entry and data analysis were done using SPSS version 22 (Statistical Package for Social
      Science). Data were presented as number, percentage, mean, standard deviation and median.
      Chi-square and Fisher Exact tests were used to compare between qualitative variables.
      Independent samples t-test was used to compare quantitative variables between two groups and
      ANOVA test for more than two groups in case of parametric data. Mann-Whitney test was used to
      compare quantitative variables between groups in case of non-parametric data. P-value
      considered statistically significant when P < 0.05.

      Results:

      The study included 35 cases of HIE (group I) and 12 cases of TTN (group II) all cases were
      full-term babies there was no significance between the two groups in the demographic data
      (sex, weight and maternal age) . There were (19) 54.3% females and (16) 47.7% males in the
      first group versus 33.3% females and 66.7% males in the 2nd group.The mean birth weight for
      the first group was 2.78 ± 0.50 kg versus 2.86 ± 0.28 kg in the second group. There were 22
      cases and 11 cases delivered by cesarean section in the 1st group and the 2nd group
      respectively. There were 13 cases and 1 case delivered by normal vaginal delivery in group I
      and group II respectively. On comparison between the two groups in measuring the serum level
      of total L carnitine. The serum level of total L carnitine had decreased in both groups with
      a mean of 5.51 ± 1.30 umol/l in group I versus 6.22 ± 2.56 umol/l in group II. Then after
      correlation between the demographic data and investigations of cases of HIE with the outcome
      there was a significant correlation between male factor and death by deaths of 66% of males
      with HIE and also there was a significant correlation between the outcome and grade III of
      HIE ( 86.7% of grade III died) .There were a significant correlation between hyponatremia
      (132.63 ± 9.30) with death of HIE cases and abnormal serum creatinine [1.4 (0.7-15.0)] with
      death of HIE cases.
    

Intervention name(s): serum L carnitine level measuring
Intervention type(s): Other
Intervention description(s): The serum level of total L carnitine was measured for both HIE and TTN cases
Observational model: Other
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        fulllterm newborn admitted to the NICU
      
Biospecimen description: 
      1 ml of newborn serum frozen to be analyzed by human ELIZA
    
Keywords: HIE,Lcarnitine level,TTN