Hello all!

Just briefly wanted to pop the question if anyone out there have experience in using LDH as a marker for tissue hypoxia and assessment of for instance birth asphyxia, TTN, other? Have seen plenty of studies and some development of different tests, point of care use and would be very grateful to your opinion on if this is something we ought to use?

All the best!

//Pontus

Wouldn’t the use be limited due to too many sources of error? You wouldn’t know if it was the liver or the kidney that took the hit.

We don't use, not reliable concerning hypoxia

Hi. We routinely do LDH levels in Post-Resuscitation term babies. It is marker of multi organ injury. Increased LDH levels >1050 IU/L in less than 12hrs predicts NE, neonatal encephalopathy. Less than 2085 IU/L carry good prognosis & if more, predicts 55% poor outcome. LDH levels > 3555 & 5090 IU / L were associated with disability and death in cooled babies Ref 1.(Sabir H et al Prediction of outcome methods assessing short-and long-term outcome after therapeutic hypothermia. SFANM 20(2015):115-121)

Ref 2. Chakradhar Maddela. A Comprehensive Clinical Approach to Hypoxic Ischemic Encephalopathy in Term Infants: A Review Acta Scientific Paediatrics 5.2(2022):37-44.

Thanks.

More than a marker of hypoxia in perinatal asphyxia, which has great diagnostic relevance, it is an important indicator of the result of the adaptive metabolic changes from aerobic anabolism to anaerobic catabolism that the fetus has had to operate by redistributing the oxygenated blood flow to noble organs. such as the brain, heart and adrenal glands, sacrificing very large organs such as skin and muscle due to decreased transplacental oxygenation in those cases with intrauterine growth restriction. Together with the concomitant alterations of creatine phosphokinase and the elevation of uric acid measured at the time of birth, hand in hand with the presence of hyperlactatemic acidosis.