Study of serum protein C level in a group of neonates with sepsis

Sepsis associated with acute organ dysfunction results from a generalized inflammatory and procoagulant response to an infection. Activated protein C, an endogenous protein that promotes fibrinolysis and inhibits thrombosis and inflammation, is an important modulator of coagulation and inflammation associated with severe sepsis. The study was conducted on twenty neonates fulfilling criteria of neonatal sepsis clinically and by laboratory investigations. Twenty healthy neonates were assigned as control group. We measured protein C level by enzyme immunoassay in both cases and control groups within 24 hours of diagnosis. Results of this study showed that there was decrease in level of protein C in neonates with sepsis when compared to control group, and this difference was statistically significant, although there was no cases in our study suffering from frank coagulation disturbances. Also gestational age, birth weight, and duration of illness were predictors of lower protein C level in study cases when doing regression analysis. We recommend larger study with measurement of levels of other protein C system in serum like active protein C and thrombomodulin assays

Study of serum markers of brain injury as early predictors of neonatal hypoxia/ischemia

Neonatal hypoxia-ischemia remains a frequent cause of cerebral palsy, mental retardation, learning disability, and epilepsy. HIE must be identified as soon after birth as possible so that appropriate measures could be taken on arrival in the neontatal intensive care unit. The aim of this study was to investigate the postnatal levels of markers of brain injury, which are CK BB and Protein S-100B in serum and to determine whether hypoxic-ischemic brain damage alters these markers and whether HIE can be predicted by elevated serum concentrations soon after birth. We have included 20 neonates with HIE together with 15 control neonates in our study. Serum concentrations of CK BB and protein S-100B were determined after birth and 24 hours of age. Our results demonstrated that cases with HIE had higher values of cord and 24 hours blood levels of CK BB, and higher values of cord and 24 hours levels of protein S-100B, and when doing statistical analysis to compare these results with those of control group, this difference was significant in all except cord level of protein S-100B. We conclude from our results that CK BB and protein S-100B are predictive of HIE in full term neonates when measure soon after birth, yet the decision as to which infants could be candidates for postasphyxial measures should probably be based on several findings, which include cord blood pH, Apgar score, and serum protein S-100 and CK-BB. Future work to establish the predictive value of these markers in long-term brain injury in neonates is recommended