Arayici Sema, Şimşek Gulsum Kadioglu, Canpolat Fuat Emre, Oncel Mehmet Yekta, Uras Nurdan, Oguz Serife Suna
Division of Neonatology, Zekai Tahir Burak Maternity Teaching Hospital, Ankara, 06230, Turkey.
Mediterr J Hematol Infect Dis. 2019 Mar 1;11(1):e2019014. doi: 10.4084/MJHID.2019.014. eCollection 2019.
Neonatal sepsis remains an important and potentially life-threatening clinical syndrome and a major cause of neonatal mortality and morbidity. The aim of this study to investigate whether values of base excess before the onset of clinical signs and symptoms of sepsis indicate infection in the early diagnosis of neonatal sepsis.
In this study, a total of 118 infants were enrolled. The infants were classified into two groups: group 1 (sepsis, n=49) and group 2 (control, n=69). Blood gas analysis investigated for the screening of neonatal sepsis.
A total of 49 newborns with neonatal sepsis and 69 healthy controls were enrolled. Comparison of markers of sepsis revealed C-reactive protein, interleukin-6 level to be significantly higher and pH, pCO, HCO and base excess values to be significantly lower in newborns with sepsis compared healthy controls (p<0.01). The optimum cut-off value in the diagnosis of neonatal sepsis was found to be -5 mmol/L for base excess. Sensitivity, specificity, positive predictive value and negative predictive value of this base excess cut-off for neonatal sepsis were 75, 91, 86 and 84% respectively.
This is the first study to determine the relationship between the decreased value of the base excess and early stage of neonatal sepsis. If the value of base excess <-5 mmol/L without an underlying another reason, may need close follow up of infants for neonatal sepsis and it may help early diagnosis.
新生儿败血症仍然是一种重要且可能危及生命的临床综合征，是新生儿死亡和发病的主要原因。本研究的目的是调查在败血症临床体征和症状出现之前的碱剩余值是否表明在新生儿败血症的早期诊断中存在感染。
在本研究中，共纳入118名婴儿。这些婴儿被分为两组：第1组（败血症组，n = 49）和第2组（对照组，n = 69）。通过血气分析筛查新生儿败血症。
共纳入49例新生儿败血症患儿和69例健康对照。败血症标志物的比较显示，与健康对照相比，败血症新生儿的C反应蛋白、白细胞介素-6水平显著升高，pH、pCO₂、HCO₃⁻和碱剩余值显著降低（p < 0.01）。发现碱剩余在新生儿败血症诊断中的最佳截断值为-5 mmol/L。该碱剩余截断值对新生儿败血症的敏感性、特异性、阳性预测值和阴性预测值分别为75%、91%、86%和84%。
这是第一项确定碱剩余值降低与新生儿败血症早期阶段之间关系的研究。如果碱剩余值<-5 mmol/L且无其他潜在原因，可能需要对婴儿进行密切随访以排查新生儿败血症，这可能有助于早期诊断。
