Early Prediction of Outcome Using Lactate Dehydrogenase and Amplitude-Integrated EEG in Transported Newborn Infants with Hypoxic-Ischaemic Encephalopathy.

AIM: To investigate whether early lactate dehydrogenase (LDH) and amplitude-integrated electroencephalography (aEEG) improve the prediction of outcome in outborn infants transported for therapeutic hypothermia. METHOD: Secondary analysis of a randomised controlled trial (2016-2019) including 113 asphyxiated newborn infants randomised to transport with a phase-change material mattress or standard care. The analysis included 81 infants with available aEEG, of whom 50 had LDH measured on admission. Outcome at 18 months was categorised as good, defined as normal development or mild delay, or poor, defined as moderate or severe impairment or death. RESULT: Mean (SD) rectal temperature on admission was lower in the PCM group (34.6 [1.1]°C vs. 35.2 [1.1]°C, p = 0.027), but the proportion within target temperature did not differ (39.5% vs. 25.6%, p = 0.235). Clinical characteristics, LDH, aEEG and outcomes were similar between groups. Poor outcome was predicted by LDH > 1000 U/L (89% sensitivity and 61% specificity), severely depressed aEEG within 12 h (87% sensitivity and 47% specificity) and the combination of both (91% sensitivity, 62% specificity and accuracy 81%). CONCLUSION: Combined LDH and aEEG provide a strong early prediction of outcome in encephalopathic infants.