Glucose-to-lactate ratio in infants with hypoxic-ischemic encephalopathy treated with hypothermia

Background: Glucose-to-lactate ratio and abnormal values of glucose and lactate blood values, as well as neuroimaging, have been reported to predict neurodevelopmental outcome in infants with hypoxic–ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH). Our aim was to confirm or confute these correlations. Methods: We retrospectively studied 48 late preterm and term infants, 31 with favourable and 17 with unfavourable outcome. Glucose-to-lactate ratio, glucose and lactate values were recorded before and during TH. They were studied with aEEG, cerebral magnetic resonance imaging (MRI), and the Bayley-III scales for assessing psychomotor development at 24 ± 2 months corrected age. Results: Logistic regression analysis demonstrated that glucose (OR 30.219, 95 % Cl 1.473–62.069, P = 0.027) and lactate (OR 1.923, 95 % Cl 1.027–3.601, P = 0.041) blood level at 24 h of TH and MRI score (OR 2.668 95 % Cl 1.060–6.713. P = 0.037) were positively correlated with unfavourable outcome. Conclusions: Glucose-to-lactate ratio did not predict neurodevelopmental outcome in infants with HIE treated with TH. Further investigation is needed to explore the prognostic significance of this biomarker. Glycemia and lactate blood levels measured at 24 h of TH, as well as cerebral MRI, are positively correlated with an increasing risk of unfavourable outcome.