The value of haematological indices of intoxication in sepsis associated respiratory distress of newborns

Abstract

Neonatal sepsis remains a significant problem in neonatal practice. However, there is a paucity of research on the prevalence, incidence, diagnosis and outcome of acute respiratory distress in a cohort of newborns with sepsis.

Aim - to evaluate changes in integral haematological indices of inflammatory syndrome activity in newborns with sepsis-associated respiratory distress in the dynamics of the disease and determine their prognostic significance. 

Materials and methods. To achieve the set goal, a comprehensive examination of 87 newborns diagnosed with neonatal sepsis. Depending on the presence of respiratory distress symptoms, newborns with neonatal sepsis were divided into two clinical groups. The group I consisted of 22 infants in whom the respiratory component was assessed at ≥2 points on the nSOFA scale, and the group II consisted of 65 newborns with a score of “0” points.

Results. Based on a comprehensive paraclinical examination and analysis of the mean group values of the integral hematological indices of inflammatory syndrome activity, no statistically significant differences were found between newborns depending on the presence or absence of respiratory disorders. However, an increase in the leukocyte intoxication index distribution point to 2.0 conventional units allowed us to establish that this level was observed in 36.4% of newborns in the group I and in 29.2% of representatives of the group II upon admission. In the dynamics after 72 hours, the frequency of registration of this indicator was 36.4% and 10.8%, respectively, which confirmed a more severe course of an inflammatory process in newborns of the group I that was insufficiently sensitive to treatment.

Conclusions. The statistically significant risk of sepsis-associated respiratory distress correlates with the severity of the infectious process, namely: at a level of leukocyte intoxication index ≥2.0 conventional units in the dynamics of treatment, there is a 4.73-fold increase in the chances of this event occurring, with a specificity of this available marker of 89.2%.

The study was conducted in accordance with the principles of the Declaration of Helsinki. The study protocol was approved by the Local Ethics Committee of the institution mentioned in the paper. The study was conducted with the informed consent of the children's parents.

The author declares no conflict of interest.