Evaluating of neonatal early onset sepsis through lactate and base excess monitoring

Abstract Early-onset sepsis (EOS) is one of the leading causes of neonatal death and morbidity worldwide and timely initiation of antibiotic therapy is, therefore, of paramount importance. This study aimed to evaluate the predictive effect of lactate and base excess (BE) values in the cord arterial...

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Main Authors: Aslan Yilmaz, Nesrin Kaya, Ilker Gonen, Abdulkerim Uygur, Yildiz Perk, Mehmet Vural
Format: Article
Language:English
Published: Nature Portfolio 2023-09-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-023-41776-0
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author Aslan Yilmaz
Nesrin Kaya
Ilker Gonen
Abdulkerim Uygur
Yildiz Perk
Mehmet Vural
author_facet Aslan Yilmaz
Nesrin Kaya
Ilker Gonen
Abdulkerim Uygur
Yildiz Perk
Mehmet Vural
author_sort Aslan Yilmaz
collection DOAJ
description Abstract Early-onset sepsis (EOS) is one of the leading causes of neonatal death and morbidity worldwide and timely initiation of antibiotic therapy is, therefore, of paramount importance. This study aimed to evaluate the predictive effect of lactate and base excess (BE) values in the cord arterial blood gas and the 6th hour of life venous blood gas analysis on clinical sepsis in newborns. This is a cohort case–control study. In this study, 104 cases were divided into clinical and suspected sepsis groups according to the evaluation at the 24th hour after delivery. Lactate and BE values were evaluated in the cord arterial blood gas analysis (ABGA) and at the postnatal 6th-hour venous blood gas. The cord ABGA and postnatal 6th-hour results were compared in the clinical and suspected sepsis groups. Clinical sepsis was found to be associated with a lactate value above 2 mMol/L at postnatal 6th-hour venous blood gas (p = 0.041). This association was the highest when the clinical sepsis group's postnatal 6th-hour lactate cut-off value was determined as 3.38 mMol/L (sensitivity 57.9% and specificity 68.5%) (p = 0.032). However, no association was found between clinical sepsis diagnosis and venous BE's value in cord ABGA at the postnatal 6th hour. We found that a venous lactate value above 3.38 mMol/L at the postnatal 6th hour was the cut-off value that could indicate early-onset clinical sepsis. However, none of the biomarkers used in diagnosing EOS can accurately show all cases.
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spelling doaj.art-87cbbb357f1946b2bc8566992eaa2fcb2023-11-20T09:28:21ZengNature PortfolioScientific Reports2045-23222023-09-011311810.1038/s41598-023-41776-0Evaluating of neonatal early onset sepsis through lactate and base excess monitoringAslan Yilmaz0Nesrin Kaya1Ilker Gonen2Abdulkerim Uygur3Yildiz Perk4Mehmet Vural5Department of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-CerrahpasaDepartment of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-CerrahpasaDepartment of Neonatology, Kanuni Sultan Süleyman Training and Research Hospital, University of Health SciencesDepartment of Public Health, Cerrahpasa Faculty of Medicine, Istanbul University-CerrahpasaDepartment of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-CerrahpasaDepartment of Neonatology, Cerrahpasa Faculty of Medicine, Istanbul University-CerrahpasaAbstract Early-onset sepsis (EOS) is one of the leading causes of neonatal death and morbidity worldwide and timely initiation of antibiotic therapy is, therefore, of paramount importance. This study aimed to evaluate the predictive effect of lactate and base excess (BE) values in the cord arterial blood gas and the 6th hour of life venous blood gas analysis on clinical sepsis in newborns. This is a cohort case–control study. In this study, 104 cases were divided into clinical and suspected sepsis groups according to the evaluation at the 24th hour after delivery. Lactate and BE values were evaluated in the cord arterial blood gas analysis (ABGA) and at the postnatal 6th-hour venous blood gas. The cord ABGA and postnatal 6th-hour results were compared in the clinical and suspected sepsis groups. Clinical sepsis was found to be associated with a lactate value above 2 mMol/L at postnatal 6th-hour venous blood gas (p = 0.041). This association was the highest when the clinical sepsis group's postnatal 6th-hour lactate cut-off value was determined as 3.38 mMol/L (sensitivity 57.9% and specificity 68.5%) (p = 0.032). However, no association was found between clinical sepsis diagnosis and venous BE's value in cord ABGA at the postnatal 6th hour. We found that a venous lactate value above 3.38 mMol/L at the postnatal 6th hour was the cut-off value that could indicate early-onset clinical sepsis. However, none of the biomarkers used in diagnosing EOS can accurately show all cases.https://doi.org/10.1038/s41598-023-41776-0
spellingShingle Aslan Yilmaz
Nesrin Kaya
Ilker Gonen
Abdulkerim Uygur
Yildiz Perk
Mehmet Vural
Evaluating of neonatal early onset sepsis through lactate and base excess monitoring
Scientific Reports
title Evaluating of neonatal early onset sepsis through lactate and base excess monitoring
title_full Evaluating of neonatal early onset sepsis through lactate and base excess monitoring
title_fullStr Evaluating of neonatal early onset sepsis through lactate and base excess monitoring
title_full_unstemmed Evaluating of neonatal early onset sepsis through lactate and base excess monitoring
title_short Evaluating of neonatal early onset sepsis through lactate and base excess monitoring
title_sort evaluating of neonatal early onset sepsis through lactate and base excess monitoring
url https://doi.org/10.1038/s41598-023-41776-0
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