Serum ischemia-modified albumin levels in neonatal sepsis and septic shock.

Yıl 2020, Cilt: 2 Sayı: 1, 7 - 12, 30.03.2020

Dilek Ulubas Ayşen Sumru Kavurt Ozge Aydemir Ahmet Yağmur Baş Nihal Demirel

Öz

Aim: Neonatal sepsis is the most common cause of morbidity and mortality. Serum ischemia modified albumin (IMA) is a specific and sensitive marker for ischemic conditions. We aimed to investigate IMA levels in neonatal sepsis and its relation to disease severity.
Material and Method: A prospective controlled study was conducted in a tertiary neonatal intensive care unit (NICU) between March 2012 and December 2012. Neonates diagnosed with sepsis younger than 28 days’ postnatal age were enrolled. Serum IMA levels with blood culture, C- reactive protein (CRP) complete blood count, and peripheral smear were obtained at the time of diagnosis. Clinical data, clinical risk index for babies (CRIB), and pediatric logistic organ dysfunction score (PELOD), septic shock, and prognosis were recorded.
Results: 39 patients and 22 healthy controls were enrolled. Mean gestational age (GA) and birth weight (BW) of patients were 30.1 ± 4.2 weeks and 1257 ± 474 g, respectively. Serum IMA levels were significantly higher in patients compared to controls (p=0.04). Serum IMA levels were higher in patients with septic shock (n=8) compared to patients without shock (n=31), but the difference was not statistically significant (p=0.348). Serum IMA levels were correlated CRIB score (p=0.008, rho=0.337), white blood count (WBC) (p=0.008, rho=0.419) and absolute neutrophil count (ANC) (p=0.006, rho=0.429).
Conclusion: Serum IMA levels were significantly higher in septic neonates. However, there was no significant difference between neonates with septic shock and without shock. Serum IMA levels may be useful in neonatal sepsis at the time of diagnosis. Further studies are needed for predicting disease severity in a larger group of septic neonates.

Anahtar Kelimeler

Ischemia modified albumin, newborn, sepsis

Neonatal sepsis ve septik şokta serum iskemi modifiye albümin düzeyleri

Öz

Amaç: Yenidoğan sepsisi en sık görülen morbidite ve mortalite nedenidir. Serum iskemi modifiye albümin (IMA), iskemik durumlar için spesifik ve hassas bir belirteçtir. Bu çalışmada yenidoğan sepsisinde IMA düzeylerini ve hastalık şiddeti ile ilişkisini araştırmayı amaçladık.
Gereç ve Yöntem: Mart 2012 ile Aralık 2012 tarihleri arasında üçüncü basamak yenidoğan yoğun bakım ünitesinde (NICU) prospektif kontrollü bir çalışma yapılmıştır. Postnatal 28 günden küçük sepsis tanısı alan bebekler çalışmaya dahil edildi. Sepsis tanısında kan kültürü, C-reaktif protein (CRP) tam kan sayımı ve periferik yayma ile birlikte serum İMA düzeylerine bakıldı. Klinik veriler, bebekler için klinik risk indeksi (CRIB) ve pediyatrik lojistik organ disfonksiyon skoru (PELOD), septik şok ve prognoz kaydedildi.
Bulgular: Çalışmaya 39 hasta ve 22 sağlıklı kontrol dahil edildi. Hastaların ortalama gebelik haftası ve doğum ağırlığı sırasıyla 30.1 ± 4.2 hafta ve 1257 ± 474 gramdı. Hastalarda serum IMA düzeyleri kontrollere göre anlamlı olarak yüksekti (p=0.04). Septik şok tanısı alan hastalarda (n=8) serum IMA düzeyleri şok olmayan hastalara göre daha yüksekti (n =31), ancak fark istatistiksel olarak anlamlı değildi (p=0.348). Serum İMA düzeyleri, beyaz hücre sayısı (p=0.008, rho=0.419), mutlak nötrofil sayısı (p=0.006, rho=0.429) ve CRIB skoru (p=0.008, rho=0.337) ile korelasyon gösterdi.
Sonuç: Sepsisli yenidoğanlarda serum İMA düzeyleri anlamlı olarak yüksek bulundu. Bununla birlikte, septik şoku olan ve olmayan yenidoğanlar arasında anlamlı bir fark yoktu. Serum İMA düzeyleri yenidoğan sepsis tanısında yararlı olabilir. Hastalığın şiddetini tahmin etmede kullanılabilmesi için sepsis tanısı olan daha çok sayıda yenidoğanda yapılan çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

İskemi modifiye albümin, yenidoğan, sepsis

Kaynakça

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