Abstract
The PCr/Pi ratio is an index of the energetic status of tissue. To see whether this ratio gave prognostic information, we used phosphorus nuclear magnetic resonance spectroscopy to measure PCr/Pi in the brains of 6 normal infants and on 71 occasions in 30 infants with neonatal neurological abnormalities due, for example, to birth-asphyxia, periventricular haemorrhage and early cerebral infarction. In the normal infants PCr/Pi ranged from 1.10 to 1.71 (mean 1.35). PCr/Pi fell below this range in 24 of the 30 abnormal infants and below 0.8 in 16 of them. 8 of the 16 infants with PCr/Pi ratios below 0.8 died in the neonatal period from predominantly cerebral causes and all 8 survivors were neurodevelopmentally abnormal at a mean age of 7 months. Among the 20 infants whose PCr/Pi ratios were always 0.8 or above, 2 died (one aged 3 weeks with congenital abnormalities including Moebius syndrome and the other, who had Prader-Willi syndrome, as a cot death aged 9 months): 3 infants were neurodevelopmentally abnormal aged 4, 9 and 10 months, and the remaining 15 infants were progressing normally at a mean age of 6 months.
We conclude that PCr/Pi ratios below 0.8 were associated with a very poor prognosis, and may indicate irreversibly deranged cerebral metabolism.
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L Costello, A., Hope, P., Cady, E. et al. Low phosphocreatine (PCr)/inorganic phosphate (P1) ratio in the brain of newborn infants indicates poor outcome. Pediatr Res 18, 798 (1984). https://doi.org/10.1203/00006450-198408000-00041
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DOI: https://doi.org/10.1203/00006450-198408000-00041