Pediatric research · 2018
Cerebral blood flow and serum neuron-specific enolase in early-onset neonatal sepsis.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод пока не подготовлен
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El Shimy Mohammed S, El-Raggal Nehal M, El-Farrash Rania A, Shaaban Hebatallah A, Mohamed Hanan E, Barakat Noha M, Farag Ahmed S, El Zohiery Abeer K, Shaaban Menat Allah A, Salama Dina H
Аннотация
BACKGROUND AND OBJECTIVES: Sepsis leads to systemic inflammatory response with cerebral blood flow (CBF) alteration and blood-brain barrier disruption that contribute to sepsis-associated encephalopathy (SAE). We aimed to evaluate cord blood neuron-specific enolase (cNSE) and CBF in early-onset neonatal sepsis (EONS) as predictors of SAE and to define short-term neurodevelopmental outcomes among survivors.
METHODS: cNSE was measured in 200 neonates with antenatal risk factors for EONS, stratified into two groups: sepsis (n = 96) and no-sepsis (n = 104). Trans-cranial Doppler of peak systolic velocities (PSV), end diastolic velocities (EDV) and resistive indices (RI) of anterior (ACA) and middle (MCA) cerebral arteries recorded on day 1 postnatal. Griffiths mental developmental scale (GMDS) was assessed at 6 months.
RESULTS: Increased cNSE, PSV, EDV, and decreased RI of both ACA and MCA were found in sepsis group compared to no-sepsis group (p < 0.001 for all). Patients with SAE (n = 34) had higher NSE, PSV, and EDV as well as lower RI of ACA and MCA compared to those without (p < 0.01 for all). SAE neonates had lower GMDS than those without. ACA RI of ≤0.61 was the best predictor of SAE.
CONCLUSION: High CBF and cNSE could be useful markers for prediction of SAE. SAE impairs neurodevelopmental scales at 6 months.
METHODS: cNSE was measured in 200 neonates with antenatal risk factors for EONS, stratified into two groups: sepsis (n = 96) and no-sepsis (n = 104). Trans-cranial Doppler of peak systolic velocities (PSV), end diastolic velocities (EDV) and resistive indices (RI) of anterior (ACA) and middle (MCA) cerebral arteries recorded on day 1 postnatal. Griffiths mental developmental scale (GMDS) was assessed at 6 months.
RESULTS: Increased cNSE, PSV, EDV, and decreased RI of both ACA and MCA were found in sepsis group compared to no-sepsis group (p < 0.001 for all). Patients with SAE (n = 34) had higher NSE, PSV, and EDV as well as lower RI of ACA and MCA compared to those without (p < 0.01 for all). SAE neonates had lower GMDS than those without. ACA RI of ≤0.61 was the best predictor of SAE.
CONCLUSION: High CBF and cNSE could be useful markers for prediction of SAE. SAE impairs neurodevelopmental scales at 6 months.
Предметные рубрики MeSH
AdultAnterior Cerebral ArteryBiomarkersBlood Flow VelocityCerebral ArteriesCerebrovascular CirculationDiastoleFemaleFetal BloodHumansInfant, NewbornInfant, Newborn, DiseasesInflammationMaleMiddle Cerebral ArteryNeonatal SepsisPhosphopyruvate HydrataseProspective StudiesRisk FactorsSystoleUltrasonography, DopplerUltrasonography, Doppler, ColorYoung Adult