Levels of Ischemia-Modified Albumin in Transient Tachypnea of the Newborn
14 March 2014
22 April 2014
10 June 2014 (online)
Aim The aim of the article is to evaluate ischemia-modified albumin (IMA) levels in infants with transient tachypnea of the newborn (TTN) and to find out its relation to the disease severity.
Patients and Methods Infants with > 37 weeks of gestation, without any respiratory and cardiac symptoms and without any maternal health problems, and diagnosed as TTN were allocated as the study group. Patients with obvious retractions, grunting, hypercarbia (Pco 2 > 60 mm Hg) or hypoxia (oxygen saturation < 88% with Fio 2 of 0.60) were managed with nasal continuous positive airway pressure (CPAP). During the postnatal 0 to 24 hours, blood samples were collected in 2 mL for IMA.
Results A total of 47 patients were diagnosed TTN, and allocated as the study group. Of the 47 patients, 43 patients without respiratory symptoms were enrolled as the control group. IMA levels in TTN were found to be significantly higher (p < 0.05). In addition, IMA levels were significantly increased in the nasal CPAP group versus supplemental oxygen therapy groups (p < 0.05). IMA levels were determined to be significantly higher in the > 3 days of oxygen therapy group (p < 0.05). IMA levels with a cutoff point of 0.87 ABSU, sensitivity of 81.1% and specificity of 69.8% predicted TTN (area under the curve [AUC] = 0.85; p < 0.05). IMA levels with > 0.98 ABSU, 78% sensitivity, and 86% specificity indicated the prediction of CPAP requirement (AUC = 0.86; p < 0.05).
Conclusion IMA levels were significantly higher in infants with diagnosed TTN. Therefore, IMA may be used as a new marker for predicting TTN and disease severity.
- 1 Hansen AK, Wisborg K, Uldbjerg N, Henriksen TB. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study. BMJ 2008; 336 (7635) 85-87
- 2 Helve O, Pitkänen O, Janér C, Andersson S. Pulmonary fluid balance in the human newborn infant. Neonatology 2009; 95 (4) 347-352
- 3 Yurdakok M, Ozek E. Transient tachypnea of the newborn: the treatment strategies. Curr Pharm Des 2012; 18 (21) 3046-3049
- 4 Sadler PJ, Tucker A, Viles JH. Involvement of a lysine residue in the N-terminal Ni2+ and Cu2+ binding site of serum albumins. Comparison with Co2+, Cd2+ and Al3+. Eur J Biochem 1994; 220 (1) 193-200
- 5 Kumral A, Okyay E, Guclu S , et al. Cord blood ischemia-modified albumin: is it associated with abnormal Doppler findings in complicated pregnancies and predictive of perinatal asphyxia?. J Obstet Gynaecol Res 2013; 39 (3) 663-671
- 6 Gugliucci A, Hermo R, Monroy C, Numaguchi M, Kimura S. Ischemia-modified albumin levels in cord blood: a case-control study in uncomplicated and complicated deliveries. Clin Chim Acta 2005; 362 (1-2) 155-160
- 7 Yakut I, Tayman C, Oztekin O, Namuslu M, Karaca F, Kosus A. Ischemia-Modified Albumin May be a Novel Marker for the Diagnosis and Follow-up of Necrotizing Enterocolitis. J Clin Lab Anal 2014; 28 (3) 170-177
- 8 Gitto E, Karbownik M, Reiter RJ , et al. Effects of melatonin treatment in septic newborns. Pediatr Res 2001; 50 (6) 756-760
- 9 Bar-Or D, Lau E, Winkler JV. A novel assay for cobalt-albumin binding and its potential as a marker for myocardial ischemia-a preliminary report. J Emerg Med 2000; 19 (4) 311-315
- 10 Jalal MAS, Respiratory disorders in pre term and term in fants. In. Martin RJ, Fanaroff AA, Walsh MC , eds. Fanaroff and Martin's Neonatal-Perinatal Medicine. 9th ed. Philadelphia, PA: Mosby; 2012: 1162-1163
- 11 Kasap B, Duman N, Özer E, Tatli M, Kumral A, Özkan H. Transient tachypnea of the newborn: predictive factor for prolonged tachypnea. Pediatr Int 2008; 50 (1) 81-84
- 12 Oztekin O, Kalay S, Tezel G, Akcakus M, Oygur N. Can we predict the duration of respiratory support in transient tachypnea of the newborn. Turk J Med Sci 2012; 42: 1494-1498
- 13 Tarcan A, Anuk D, Cındık N, Gürakan B. Risk factors for prolongation of disease in transient tachypnea of the newborn. Turkiye Klinikleri J Pediatr 2004; 13: 224-226
- 14 Pesonen E, Heldt GP, Merritt TA , et al. Atrial natriuretic factor and pulmonary status in premature infants with respiratory distress syndrome: preliminary investigation. Pediatr Pulmonol 1993; 15 (6) 362-364
- 15 Onal EE, Dilmen U, Adam B, Türkyilmaz C, Uysal FK, Oğuz D. Serum atrial natriuretic peptide levels in infants with transient tachypnea of the newborn. J Matern Fetal Neonatal Med 2005; 17 (2) 145-149
- 16 Aydemir O, Aydemir C, Sarikabadayi YU , et al. The role of plasma N-terminal pro-B-type natriuretic peptide in predicting the severity of transient tachypnea of the newborn. Early Hum Dev 2012; 88 (5) 315-319
- 17 Ozkiraz S, Gokmen Z, Boke SB, Kilicdag H, Ozel D, Sert A. Lactate and lactate dehydrogenase in predicting the severity of transient tachypnea of the newborn. J Matern Fetal Neonatal Med 2013; 26 (12) 1245-1248
- 18 Shen XL, Lin CJ, Han LL, Lin L, Pan L, Pu XD. Assessment of ischemia-modified albumin levels for emergency room diagnosis of acute coronary syndrome. Int J Cardiol 2011; 149 (3) 296-298
- 19 Dominguez-Rodriguez A, Abreu-Gonzalez P. Current role of ischemia-modified albumin in routine clinical practice. Biomarkers 2010; 15 (8) 655-662
- 20 Sbarouni E, Georgiadou P, Kremastinos DT, Voudris V. Ischemia modified albumin: is this marker of ischemia ready for prime time use?. Hellenic J Cardiol 2008; 49 (4) 260-266
- 21 Gaze DC. Ischemia modified albumin: a novel biomarker for the detection of cardiac ischemia. Drug Metab Pharmacokinet 2009; 24 (4) 333-341
- 22 Gunduz A, Turkmen S, Turedi S , et al. Time-dependent variations in ischemia-modified albumin levels in mesenteric ischemia. Acad Emerg Med 2009; 16 (6) 539-543