Geç Neonatal Sepsiste, Trombosit ve Eritrosit İndeksleri ve Prognoza Etkisi

Year 2025, Volume: 22 Issue: 1, 97 - 103

Halil Dolap , Doğan Köse

https://doi.org/10.35440/hutfd.1562572

Abstract

Amaç: Yenidoğanların mortalite ve morbiditesinin en önemli nedenlerin biri yenidoğan sepsisidir. Tanı ve tedavisindeki tüm gelişmelere rağmen önemli bir halk sağlığı sorunu olarak karşımıza çıkmaktadır. Bu araştırmada, geç başlangıçlı sepsis tanısı ile yenidoğan yoğun bakım ünitesine (YYBÜ) yatışı yapılan yenidoğanların tedavinin başlangıcı ve 7.gündeki hemogram parametrelerinin değerlendirilmesi amaç-lanmaktadır.
Materyal ve Metod: Bu araştırma Ocak 2017-Şubat 2020 tarihleri arasında bir üniversite hastanesinin YYBÜ’sinde geç başlangıçlı yenidoğan sepsisi tanısıyla bakım ve tedavi almış yenidoğanlarla kesitsel tipte yürütülmüştür. Postnatal 72. saat ile 30. günler arasında olan ve kan veya idrar kültüründe üre-mesi olan yenidoğanlar araştırmaya dahil edildi. Araştırmanın verileri dijital ortamda retrospektif olarak sepsisin 1. ve 7. günlerinde alınan hemogram parametreleri, CRP düzeyleri, girişimsel işlem durumu, kültürün alındığı vücut sıvısı, kültür sonucu, başlangıçta uygulanan tedavi, takip ve tedaviler-de yapılan değişim, yatış nedeni ve mortalite gibi durumların taranması sonucunda elde edilmiştir.
Bulgular: Yenidoğanların %58.4’ünün erkek ve %50.6’sının term bebek olduğu belirlenmiştir. Yaşamını kaybeden yenidoğanların sepsisin 7. gününde RBC ve MCH düzeyleri, sepsisin 1. gününde MCV düzey-leri ile 1. ve 7. günlerinde HGB, HCT ve PLT düzeyleri yaşayan yenidoğanlara göre istatistiksel olarak anlamlı düzeyde daha düşük saptanmıştır. Ayrıca, yaşamını kaybeden yenidoğanların sepisinin 1. gü-nünde MPV düzeyleri ile 1. ve 7. günlerinde CRP düzeyleri yaşayan yenidoğanlara göre istatistiksel olarak anlamlı seviyede daha yüksek olarak tespit edilmiştir.
Sonuç: Sonuçlardan anlaşılacağı üzere geç başlangıçlı sepsis tanılı yenidoğanların takibinde sepisinin 7. günü RBC ve MCH düzeyleri, sepsisin 1. günü MCV düzeyleri ile sepsisin 1. günü ve 7. günü HGB, HCT ve PLT düzeylerinin düşüklüğünün ve sepsinin 1. günü ve 7. günü CRP düzeyleri ile sepsisin 1. gününde MPV düzeylerinin yüksekliğinin kötü prognostik faktör olarak değerlendirilmesi gerektiği ve mortalite ile ilişkili olduğu kanıtlanmıştır.

Anahtar Kelimeler: Geç başlangıçlı yenidoğan sepsisi; Prognoz; Trombosit; Eritrosit

Keywords

Geç başlangıçlı Neonatal sepsis, Prognoz, Trombosit, Eritrosit

Project Number

No

Platelet and Erythrocyte Indices and Their Impact on Prognosis in Late Neonatal Sepsis

Abstract

Background: One of the most significant causes of mortality and morbidity in newborns is neonatal sepsis. Despite all the advancements in its diagnosis and treatment, it remains a major public health issue. This study aims to evaluate the hemogram parameters of newborns admitted to the neonatal intensive care unit (NICU) with a diagnosis of late-onset neonatal sepsis, both at the start of treatment and on the 7th day.
Materials and Methods: This study was conducted in a cross-sectional manner with 89 newborns who received care and treatment for late-onset neonatal sepsis in the neonatal intensive care unit (NICU) of a university hospital between January 2017 and February 2020. Newborns between the postnatal 72nd hour and 30th day with positive blood or urine cultures were included in the study. The data of the study were obtained retrospectively in the digital environment by screening hemogram parame-ters, CRP levels, interventional procedure status, body fluid from which the culture was taken, culture result, initial treatment, follow-up and change in treatments, reason for hospitalization and mortality on the 1st and 7th days of sepsis.
Results: It was determined that 58.4% of the newborns were male and 50.6% were term newborns. RBC and MCH levels on the 7th day of sepsis, MCV levels on the 1st day of sepsis, HGB, HCT and PLT levels on the 1st and 7th days of sepsis were found to be statistically significantly lower in newborns who lost their lives compared to living newborns. In addition, MPV levels on the 1st day of sepsis and CRP levels on the 1st and 7th days of sepsis of newborns who died were found to be statistically signi-ficantly higher than those of living newborns.
Conclusions: As can be understood from the results, it has been proven that low RBC and MCH levels on the 7th day of sepsis, MCV levels on the 1st day of sepsis, HGB, HCT and PLT levels on the 1st day and 7th day of sepsis, and high CRP levels on the 1st day and 7th day of sepsis and MPV levels on the 1st day of sepsis should be considered as poor prognostic factors and are associated with mortality in the follow-up of newborns diagnosed with late-onset sepsis.

Keywords

Late-onset Neonatal Sepsis, Prognosis, Platelet, Erythrocyte

Ethical Statement

Before starting the study, approval from the clinical research ethics committee of a university was obtained with the decision numbered 19/09/15 dated 22.10.2019 and institutional permission from the hospital where the study was conducted. The study was conducted in accordance with the principles of the Declaration of Helsinki.

Supporting Institution

This study has not been supported by any funding.

Project Number

No

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