Background and aim Hypoxic ischaemic encephalopathy (HIE) is associated with hepatic dysfunction as evidenced by raised alanine transferase (ALT). Our aim was to assess biochemical liver function in neonates with HIE and the effect of cooling.
Methods Retrospective study of 70 neonates admitted to our tertiary-level NICU with HIE. We examined ALT concentrations measured on postnatal days 0, 3 and 7 and compared it with clinical grade of HIE (Sarnat-Sarnat classification). ALT concentrations were compared with infants who had received therapeutic hypothermia against infants who had not received therapeutic hypothermia (control).
Results Serum ALT levels were significantly greater with increasing severity of encephalopathy on day 1 (p=0.003) where as the day 3 (p=0.100) and day 7 (p=0.125) concentrations were not significantly different.
There was significant decrease in ALT concentrations on day 3 among the infants who were cooled (n=47) versus those who were not cooled (n=24), where as no such difference was noted on DAY 1 ALT concentrations (table 1).
Conclusion In asphyxiated neonates, ALT concentrations strongly correlate strongly with clinical grade of HIE on day 0. This study also provides evidence that cooling is hepatoprotective with significant difference in ALT concentrations after 3 days of cooling.