PEDIATRICS Vol. 64 No. 3 September 1979, pp. 336-341
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Hyperammonemia Associated with Perinatal Asphyxia

Ronald N. Goldberg MD1, Luis A. Cabal MD1, Frank R. Sinatra MD1, Carolyn E. Plajstek RN1, and Joan E. Hodgman MD1

1 Department of Pediatrics, University of Southern California School of Medicine and the Neonatal-Respiratory Diseases Division, Childrens Hospital of Los Angeles, and Newborn Division, Los Angeles County-University of Southern California Medical Center, Los Angeles

Twelve infants with severe perinatal asphyxia were found to have elevated blood ammonia levels (302 to 960 µg/100 ml). In the seven survivors, hyperammonemia was associated with CNS irritability, hyperthermia, hypertension, and wide neonatal heart rate oscillations. Follow-up examinations revealed severe neurologic dysfunction in five of seven infants. CNS depression, hyperthermia, hypertension, and a nonreactive, fixed heart rate characterized the infants that died. These findings suggest a clinical entity secondary to perinatal asphyxia whose signs and symptoms may be related to hyperammonemia.

Submitted on November 2, 1978
Accepted on February 12, 1979




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