This is a presentation from my seminar in biological sciences course. The presentations discusses serum ischemia-modified albumin in preterm babies with respiratory distress syndrome.

1. Serum Ischemia-Modified
Albumin in Preterm Babies
with Respiratory Distress
Syndrome
Hasan Kahveci ,Cuneyt Tayman, Fuat Laoglu, Huseyin Tugrul Celik, Nazan Kavas, Omer Kılıc, Salih Aydemir
1 Division of Neonatal Intensive Care Unit, Erzurum District Training and Research Hospital, Erzurum, Turkey 2 Department of Neonatology,
Denizli T.C. Public Health Hospital, 2010, Denizli, Turkey 3 Division of Neonatal Intensive Care Unit, Nenehatun Obstetrics Hospital, Erzurum,
Turkey 4 Department of Biochemistry, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey 5 Division of Pediatric Infectious Diseases,
Erzurum District Training and Research Hospital, Erzurum, Turkey 6 Department of Pediatrics, Dr. Sami Ulus Children Research and Training
Hospital, Ankara, Turkey
5580132

2. Respiratory distress syndrome
Also called hyaline membrane disease
Usually occurs in premature infants
Risk of RDS increases with decreasing gestational age and birth weight
Caused by impaired gas exchange, decreased compliance, alveolar
collapse, pulmonary edema, and lung injury

3. Respiratory distress syndrome (continued)
Symptoms include cyanosis, grunting, retractions and tachypnea
Signs include decreased pulmonary ventilation, perfusion hypoxia,
hypercapnia, and acidosis

4. Pathogenesis

5. Human serum albumin
Human serum albumin: protein found in human blood plasma
Functions
• Maintains oncotic pressure
• Transports hormones
• Transports fatty acids ("free" fatty acids) to the liver and to
myocytes for energy
• Transports bilirubin
• Transports drugs
• Competitively binds calcium ions (Ca2+)
• Buffers pH
• Indicator for inflammation
• Prevents photodegradation of folic acid

6. Ischemia modified albumin
Ischemia modified albumin lacks binding with metals such as cobalt,
nickel, and copper
Hypoxia, acidosis, or ischemia reduces the binding capacity of HSA to
metals leading to ischemia modified albumin
IMA increases after an ischemic event

8. Subjects
Experimental: 37 infants with RDS
Control: 42 premature infants

9. Inclusion criteria
Included Excluded
Preterm births less than 34 weeks by singleton
pregnancies
Chorioamnionitis
Abnormal fetal karyotype
Smoking
Neonatal hypoglycemia
Neonatal hypoalbuminemia
Elevated levels of C-reactive protein
Major congenital somatic anomalies
Congenital heart disease
Intrauterine growth restriction
Placental abruption
Antenatal heart rate deceleration
Asphyxia
Elevated levels of enzymes (i.e. AST, ALT, LDH, CK)

10. Methods & Outcomes
Baseline characteristics of infants were obtained from medical records
Blood sample was collected and separated for obtaining serum
albumin
Serum albumin was screened using an ischemia modified albumin
assay to determine IMA levels

12. Results

13. APGAR

14. Receiver operating characteristic curve

15. Elevated IMA levels in the blood can be used
as a diagnostic marker for hypoxia in
newborns with RDS

16. Discussion
Can result from oxidative stress : generation of superoxide-free
oxygen radicals that occur during ischemic events, regardless of tissue
specificity
IMA has a relationship with various ischemia-related conditions,
such as acute coronary syndrome and ischemia of liver, brain, kidney,
and bowel in adults
V/Q mismatch or right-to-left shunting, diffusion abnormalities and
hypoventilation can decrease oxygenation and lead to hypoxia

18. Serum Ischemia-Modified
Albumin in Preterm Babies
with Respiratory Distress
Syndrome
Hasan Kahveci ,Cuneyt Tayman, Fuat Laoglu, Huseyin Tugrul Celik, Nazan Kavas, Omer Kılıc, Salih Aydemir
1 Division of Neonatal Intensive Care Unit, Erzurum District Training and Research Hospital, Erzurum, Turkey 2 Department of Neonatology,
Denizli T.C. Public Health Hospital, 2010, Denizli, Turkey 3 Division of Neonatal Intensive Care Unit, Nenehatun Obstetrics Hospital, Erzurum,
Turkey 4 Department of Biochemistry, Faculty of Medicine, Turgut Ozal University, Ankara, Turkey 5 Division of Pediatric Infectious Diseases,
Erzurum District Training and Research Hospital, Erzurum, Turkey 6 Department of Pediatrics, Dr. Sami Ulus Children Research and Training
Hospital, Ankara, Turkey