Relationship between systemic inflammatory response syndrome and degree of brain damage and prognosis following severe asphyxia in neonates after asphyxia treated by resuscitation

Objective:To study relationship between systemic inflammatory response syndrome (SIRS) and degree of brain damage and prognosis following severe asphyxia in neonates after asphyxia treated by resuscitation.Methods:52 full-term neonates with severe asphyxia and SIRS admitted to this NICU (SIRS group) were reviewed retrospectively from Jan. 1999 to Dec. 2004, and 40 neonates with severe asphyxia and non-SIRS during this period were selected as control group (non-SIRS group).Data about the SIRS diagnostic criteria were collected in all patients within the first 72 hours after birth, and all patients were scored within the 24 hours after birth according to the criteria of the critical-score-system for neonatal acute severity. The degree of hypoxic-ischemic encephalopathy (HIE) was also evaluated, and the Neonatal Behavioral Neurological Assessment (NBNA) was done.The mortality were also observed in both groups.Results:The percentage of critical cases and mortality rate in SIRS newborns increased with increasing items of criteria for diagnosis of SIRS (χ2=8.791 7, P0.01;χ2=11.031 8,P0.01 respectively).The incidence of severe HIE was also significantly higher in the SIRS group than that in the non-SIRS group (χ2=18.532 0,P0.01). The percentage of the survivors whose NBNA marks were less than 35 at 12~14 d after birth in the SIRS group was much higher than that in the non-SIRS group (χ2=4.390 5,P0.05).Conclusion:The occurrence of SIRS remarkably correlated with the development of the disease following asphyxia and the outcome of the illness.The newborns with SIRS following asphyxia might have more severe brain damage and their prognoses might be more undesirable.