RESUMO
OBJECTIVE: To evaluate mannose-binding lectin (MBL) serum levels as a marker for predicting sepsis, septic shock, and their outcomes in neonates. PATIENTS AND METHODS: A prospective study was conducted on 62 neonates (27 preterm and 35 full term) with culture-proven sepsis and 35 controls. Serum levels of MBL were measured by immunoassay. RESULTS: Of 62 infants with positive blood cultures (Gram-negativeâ=â44 and Gram-positiveâ=â18), 11 infants had severe sepsis and 6 neonates developed septic shock. MBL levels were significantly lower in infants with sepsis than in control group (0.39â±â0.07 vs. 1.34â±â0.03 µg/ml; pâ<â0.001). The lowest MBL levels were detected in those infants with septic shock, particularly those who died (pâ<â0.05). MBL had high sensitivity (96.7), specificity (97.1), positive (98.3), and negative (94.4) predictive values to detect sepsis. CONCLUSION: Low MBL serum levels could be considered as sensitive and specific marker for predicting sepsis, septic shock, and their clinical outcomes in newborn infants.
Assuntos
Doenças do Recém-Nascido/sangue , Lectina de Ligação a Manose/sangue , Sepse/sangue , Choque Séptico/sangue , Peso ao Nascer/fisiologia , Estudos de Casos e Controles , Feminino , Infecções por Bactérias Gram-Negativas/sangue , Infecções por Bactérias Gram-Negativas/complicações , Infecções por Bactérias Gram-Negativas/epidemiologia , Infecções por Bactérias Gram-Positivas/sangue , Infecções por Bactérias Gram-Positivas/complicações , Infecções por Bactérias Gram-Positivas/epidemiologia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/diagnóstico , Doenças do Recém-Nascido/epidemiologia , Recém-Nascido Prematuro/sangue , Doenças do Prematuro/sangue , Doenças do Prematuro/epidemiologia , Unidades de Terapia Intensiva Neonatal/estatística & dados numéricos , Masculino , Lectina de Ligação a Manose/análise , Gravidez , Complicações Infecciosas na Gravidez/sangue , Complicações Infecciosas na Gravidez/epidemiologia , Arábia Saudita/epidemiologia , Sepse/congênito , Sepse/diagnóstico , Sepse/epidemiologia , Choque Séptico/congênito , Choque Séptico/diagnóstico , Choque Séptico/epidemiologiaRESUMO
Shock is a clinical disorder that challenges caregivers in the neonatal intensive care unit. The predominant cause of shock in neonates is sepsis. This article provides an overview of the current treatment of septic shock with particular emphasis on newer vasoactive drugs (milrinone, levosimendan and vasopressin) to support cardiovascular dysfunction.
Assuntos
Unidades de Terapia Intensiva Neonatal/tendências , Neonatologia/tendências , Choque Séptico/congênito , Choque Séptico/terapia , Humanos , Recém-Nascido , Doenças do Recém-Nascido/terapia , Neonatologia/métodos , Choque/congênito , Choque/diagnóstico , Choque/terapia , Choque Séptico/diagnósticoRESUMO
The effect of preliminary short-term irradiation with He-Ne laser light (632.8 nm, 0.2 mW/cm2) of the thymus zone projection of male NMRI mice subjected to acute toxic stress on the responses of immune cells was studied. Stress was modeled by lipopolysaccharide injection, 250 mg/100 g of body weight, which induced a significant increase in the production of several macrophage cytokines, IL-1alpha, IL-1beta, IL-6, IL-10 and TNF-alpha. A single irradiation with laser light did not provoke considerable variations in NO production in cells but induced an enhancement in the production of heat shock proteins Hsp25, Hsp70, and Hsp90. Nevertheless, when irradiation with red laser light was applied prior to toxic stress, considerable normalization of production of nearly all cytokines studied and nitric oxide was observed. Moreover, the normalization of production of heat shock proteins has been shown in these conditions. Thus, preliminary exposure of a small area of animal skin surface provoked a significant lowering in the toxic effect of lipopolysaccharide.
