Abstract

To evaluate creatine kinase-myocardial band(CK-MB) levels in neonatal shock and its relation to type ,doses and duration of inotropic support and outcome. STUDY DESIGN: It was a prospective hospital based study , conducted over 2 years in neonatal intensive care unit of a government teaching hospital. MATERIALS AND METHODS:Cases were selected by purposive-deliberate sampling as and when serially diagnosed.Shock was diagnosed clinically and was managed as per American College of Critical Care Medicine guidelines.CK-MB level was assessed by immunoinhibition enzyme assay method within 12-24 hours of onset of shock. Demographic and clinical profile of babies was noted on predesigned proforma.Primary outcome was time to come out of shock and secondary outcome was type of oxygen support, acute kidney injury and disseminated intravascular coagulation. Data was analyzed statistically by Kruskal Wallis , Mann-Whitney U test and Spearman’s rho. RESULTS: 211 babies formed the study subjects. There were119 male and 92 female babies.Maximum babies(45.97%) were between 32-34w gestation. The mean weight of babies was 1850.12±525.45g and mean gestation was 33.77±2.68w. Majority(58.77%) of babies were Appropriate for Gestational Age(AGA). Mean CK-MB level was 102.93±77.87 IU/L. The difference in levels of CK-MB in relation to types(p=0.846) and doses of inotropes was statistically non significant(p>.05).The CK-MB level was also non significant in relation to duration of inotropic support. The level of CK-MB was statistically significant in non survivors as compared to survivors(p=0.002). CONCLUSION: The CK-MB levels are not decisive in deterimining the type and doses of inotropes, but do predict mortality in neonatal shock.

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