CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT
Abstract Background: To evaluate carboxyhemoglobin (COHb) levels in diagnosing late-onset sepsis (LOS) in preterm neonates. Methods: The records of culture-positive LOS in preterm neonates hospitalized in NICU from January 2017 to July 2022 were reviewed.COHb levels, C-reactive protein, proca...
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| Format: | Article |
| Language: | English |
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Mattioli1885
2023-02-01
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| Series: | Mediterranean Journal of Hematology and Infectious Diseases |
| Subjects: | |
| Online Access: | http://www.mjhid.org/index.php/mjhid/article/view/5205 |
| _version_ | 1811162613986361344 |
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| author | GONCA VARDAR Eren Ozek |
| author_facet | GONCA VARDAR Eren Ozek |
| author_sort | GONCA VARDAR |
| collection | DOAJ |
| description |
Abstract
Background: To evaluate carboxyhemoglobin (COHb) levels in diagnosing late-onset sepsis (LOS) in preterm neonates.
Methods: The records of culture-positive LOS in preterm neonates hospitalized in NICU from January 2017 to July 2022 were reviewed.COHb levels, C-reactive protein, procalcitonin, and neutrophil to lymphocyte ratio of septic preterm infants were compared to controls. Serial COHb levels measured within six hours before or 24h after blood culture sampling, three to seven days prior, and three to five days after starting antimicrobial therapy were retrieved from patient records.
Results: The study included 77 blood-culture-positive preterm infants and 77 non-septic controls. During the LOS episode, the COHb values were found to be significantly increased (median: 1.8, IQR: 1.4-2.5) when compared to the control group (median: 1.2, IQR: 0.8-1.6) (p < 0.001). ROC analysis yielded an AUC of 0.714 for COHb (95% CI: 0.631-0.796, p<0.001). At an optimal cut-off of >1.5%, the test’s sensitivity was 64.94%, the specificity was 72.73%, the positive predictive value was 70.42%, and the negative predictive value was 67.47%.LOS led to a dramatic rise followed by a decrease after the initiation of the antimicrobial therapy [1.8 (1.4-2.5) ] vs. [1.45 (0.2-4)] p<0.001.
Conclusion: COHb levels increased at the beginning of LOS, decreasing in response to antibiotics. When used in conjunction with other sepsis biomarkers, the variation of COHb can be important in evaluating a LOS episode in preterm infants. COHb can be utilized as a quick, bedside approach for detecting LOS in preterm neonates in NICUs.
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| first_indexed | 2024-04-10T06:33:17Z |
| format | Article |
| id | doaj.art-ba9d51370093487fab8cfc9ff0991c8a |
| institution | Directory Open Access Journal |
| issn | 2035-3006 |
| language | English |
| last_indexed | 2024-04-10T06:33:17Z |
| publishDate | 2023-02-01 |
| publisher | Mattioli1885 |
| record_format | Article |
| series | Mediterranean Journal of Hematology and Infectious Diseases |
| spelling | doaj.art-ba9d51370093487fab8cfc9ff0991c8a2023-03-01T05:22:59ZengMattioli1885Mediterranean Journal of Hematology and Infectious Diseases2035-30062023-02-0115110.4084/MJHID.2023.017CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT GONCA VARDAR0Eren Ozek1a:1:{s:5:"en_US";s:37:"Marmara University School of Medicine";}Marmara University School of Medicine, Istanbul, Turkey. Abstract Background: To evaluate carboxyhemoglobin (COHb) levels in diagnosing late-onset sepsis (LOS) in preterm neonates. Methods: The records of culture-positive LOS in preterm neonates hospitalized in NICU from January 2017 to July 2022 were reviewed.COHb levels, C-reactive protein, procalcitonin, and neutrophil to lymphocyte ratio of septic preterm infants were compared to controls. Serial COHb levels measured within six hours before or 24h after blood culture sampling, three to seven days prior, and three to five days after starting antimicrobial therapy were retrieved from patient records. Results: The study included 77 blood-culture-positive preterm infants and 77 non-septic controls. During the LOS episode, the COHb values were found to be significantly increased (median: 1.8, IQR: 1.4-2.5) when compared to the control group (median: 1.2, IQR: 0.8-1.6) (p < 0.001). ROC analysis yielded an AUC of 0.714 for COHb (95% CI: 0.631-0.796, p<0.001). At an optimal cut-off of >1.5%, the test’s sensitivity was 64.94%, the specificity was 72.73%, the positive predictive value was 70.42%, and the negative predictive value was 67.47%.LOS led to a dramatic rise followed by a decrease after the initiation of the antimicrobial therapy [1.8 (1.4-2.5) ] vs. [1.45 (0.2-4)] p<0.001. Conclusion: COHb levels increased at the beginning of LOS, decreasing in response to antibiotics. When used in conjunction with other sepsis biomarkers, the variation of COHb can be important in evaluating a LOS episode in preterm infants. COHb can be utilized as a quick, bedside approach for detecting LOS in preterm neonates in NICUs. http://www.mjhid.org/index.php/mjhid/article/view/5205Late-onset sepsis, carboxyhemoglobin, preterm neonates, biomarker |
| spellingShingle | GONCA VARDAR Eren Ozek CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT Mediterranean Journal of Hematology and Infectious Diseases Late-onset sepsis, carboxyhemoglobin, preterm neonates, biomarker |
| title | CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT |
| title_full | CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT |
| title_fullStr | CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT |
| title_full_unstemmed | CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT |
| title_short | CARBOXYHEMOGLOBIN LEVELS IN PRETERM NEONATAL LATE-ONSET SEPSIS: TO PREDICT OR NOT TO PREDICT |
| title_sort | carboxyhemoglobin levels in preterm neonatal late onset sepsis to predict or not to predict |
| topic | Late-onset sepsis, carboxyhemoglobin, preterm neonates, biomarker |
| url | http://www.mjhid.org/index.php/mjhid/article/view/5205 |
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