Early Blood Pressure Changes in Neonatal Sepsis and the Risk of Mortality
© 2023. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation..
OBJECTIVES: To compare blood pressures (BP) between neonates with culture-proven sepsis and clinical sepsis in the first 120 h of sepsis onset and to examine association between BP and in-hospital mortality.
METHODS: In this cohort study, consecutively enrolled neonates with 'culture-proven' sepsis [growth in blood/ cerebrospinal fluid (CSF) within 48 h] and clinical sepsis (sepsis workup negative, cultures sterile) were analyzed. Their BP was recorded every 3-hourly for initial 120 h and averaged in 20 time-epochs of 6 h each (0-6 h to 115-120 h). BP Z-scores were compared between neonates with culture-proven vs. clinical sepsis and survivors vs. non-survivors.
RESULTS: Two hundred twenty eight neonates (102-culture-proven and 126-clinical sepsis) were enrolled. Both groups had comparable BP Z-scores except significantly lower diastolic BP (DBP) and mean BP (MBP) in 0-6 and 13-18 time-epochs in culture-proven sepsis group. Fifty-four neonates (24%) died during their hospital stay. BP Z-scores in the initial 54 h of sepsis were independently associated with mortality [systolic BP (SBP) Z-scores in first 54 h, DBP Z-scores in first 24 h, and MBP Z-scores in first 24 h] after adjusting for gestational age, birth weight, cesarean delivery, and 5-min Apgar score. On receiver operating characteristic curves, SBP Z-scores showed better discriminative ability than DBP and MBP to identify non-survivors.
CONCLUSIONS: Neonates with culture-proven and clinical sepsis had comparable BP Z-scores except low DBP and MBP in the initial few hours in culture-proven sepsis. BP in initial 54 h of sepsis was significantly associated with in-hospital mortality. SBP discriminated non-survivors better than DBP and MBP.
| Errataetall: |
CommentIn: Indian J Pediatr. 2023 Nov;90(11):1071-1072. - PMID 37587383 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:90 |
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| Enthalten in: |
Indian journal of pediatrics - 90(2023), 11 vom: 24. Nov., Seite 1096-1102 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Saini, Shiv Sajan [VerfasserIn] |
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| Links: |
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| Themen: |
Arterial pressure |
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| Anmerkungen: |
Date Completed 23.10.2023 Date Revised 06.11.2023 published: Print-Electronic CommentIn: Indian J Pediatr. 2023 Nov;90(11):1071-1072. - PMID 37587383 Citation Status MEDLINE |
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| doi: |
10.1007/s12098-023-04597-7 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM357283430 |
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| 500 | |a Date Revised 06.11.2023 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a CommentIn: Indian J Pediatr. 2023 Nov;90(11):1071-1072. - PMID 37587383 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023. The Author(s), under exclusive licence to Dr. K C Chaudhuri Foundation. | ||
| 520 | |a OBJECTIVES: To compare blood pressures (BP) between neonates with culture-proven sepsis and clinical sepsis in the first 120 h of sepsis onset and to examine association between BP and in-hospital mortality | ||
| 520 | |a METHODS: In this cohort study, consecutively enrolled neonates with 'culture-proven' sepsis [growth in blood/ cerebrospinal fluid (CSF) within 48 h] and clinical sepsis (sepsis workup negative, cultures sterile) were analyzed. Their BP was recorded every 3-hourly for initial 120 h and averaged in 20 time-epochs of 6 h each (0-6 h to 115-120 h). BP Z-scores were compared between neonates with culture-proven vs. clinical sepsis and survivors vs. non-survivors | ||
| 520 | |a RESULTS: Two hundred twenty eight neonates (102-culture-proven and 126-clinical sepsis) were enrolled. Both groups had comparable BP Z-scores except significantly lower diastolic BP (DBP) and mean BP (MBP) in 0-6 and 13-18 time-epochs in culture-proven sepsis group. Fifty-four neonates (24%) died during their hospital stay. BP Z-scores in the initial 54 h of sepsis were independently associated with mortality [systolic BP (SBP) Z-scores in first 54 h, DBP Z-scores in first 24 h, and MBP Z-scores in first 24 h] after adjusting for gestational age, birth weight, cesarean delivery, and 5-min Apgar score. On receiver operating characteristic curves, SBP Z-scores showed better discriminative ability than DBP and MBP to identify non-survivors | ||
| 520 | |a CONCLUSIONS: Neonates with culture-proven and clinical sepsis had comparable BP Z-scores except low DBP and MBP in the initial few hours in culture-proven sepsis. BP in initial 54 h of sepsis was significantly associated with in-hospital mortality. SBP discriminated non-survivors better than DBP and MBP | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Arterial pressure | |
| 650 | 4 | |a Blood pressure | |
| 650 | 4 | |a Infant, Newborn | |
| 650 | 4 | |a Neonatal sepsis | |
| 700 | 1 | |a Shrivastav, Amit Kumar |e verfasserin |4 aut | |
| 700 | 1 | |a Sundaram, Venkataseshan |e verfasserin |4 aut | |
| 700 | 1 | |a Dutta, Sourabh |e verfasserin |4 aut | |
| 700 | 1 | |a Kumar, Praveen |e verfasserin |4 aut | |
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