Cerebral blood flow and serum neuron-specific enolase in early-onset neonatal sepsis

Shimy, Mohammed S El; El-Raggal, Nehal M; El-Farrash, Rania A.; Shaaban, Hebatallah A; Mohamed, H. E.; Barakat, Noha M.; Farag, Ahmed S; Zohiery, Abeer K. El; Shaaban, Menat Allah; Salama, Dina H.

doi:10.1038/s41390-018-0062-4

Cited by 24 publications

(16 citation statements)

References 39 publications

(40 reference statements)

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“…The peak systolic velocity values in our study showed higher Mean values than that recorded by Sriparna et al 6 , which can be explained by the difference in timing of transcranial Doppler examination, and according to researches CBFV rise progressively with the postnatal age. 14 Also, our results were in accordance with those of Hashem et al 5 who found increased peak systolic velocity and lower resistance in neonates with EONS by examination of the ACA and MCA in preterm neonates at the third day after birth, and El Shimy et al 15 who found that neonates with EONS had raised cerebral blood flow and neuron-specific enolase in cord blood.…”

Section: Discussionsupporting

confidence: 91%

Efficacy of Cranial Doppler ultrasound in Diagnosis of Early-onset neonatal sepsis

Elheity

Abdelhakeem

Ahmed

et al. 2021

Al-Azhar International Medical Journal

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Background: Neonatal sepsis is considered a major neonatal issue and associated with a high rate of mortality in newborns. Because there is a lack of studies concerning early hemodynamic changes of cerebral circulation in neonatal sepsis, so our research aims to assess the cerebral blood flow (CBF) changes in newborns with early onset neonatal sepsis (EONS) and to clarify the role of cranial Doppler Ultrasound in EONS diagnosis. Aim of The Work:To evaluate cerebral hemodynamic changes using transcranial Doppler in newborns with EONS. Patient and Methods: This cross sectional study with 50 neonates involved in the study. The neonates were classified into 2 groups: Case Group (25 neonates) with a diagnosis of early-onset neonatal sepsis and control group (25 neonates) without clinical manifestations of sepsis. Examination of all neonates using Transcranial Doppler (TCD) was performed within seventy-two hours after birth. Measurement of cerebral blood flow velocity (CBFV) in two major cerebral vessels: The anterior cerebral artery (ACA) and middle cerebral artery (MCA) with documentation of doppler data: The peak systolic velocity (PSV), pulsatility index (PI), and resistive index (RI). Data were statistically analyzed followed by calculation of specificity, sensitivity, positive and negative predictive value at selected cut-off values of CBFV parameters. Results: Sepsis group showed statistically significant changes in doppler indices with increased PSV and deceased PI and RI in both arteries. Conclusion:The present study demonstrates changes in CBFV measured by transcranial Doppler in newborns with EONS which can be used as noninvasive bedside investigation.

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Section: Discussionsupporting

confidence: 91%

Efficacy of Cranial Doppler ultrasound in Diagnosis of Early-onset neonatal sepsis

Elheity

Abdelhakeem

Ahmed

et al. 2021

Al-Azhar International Medical Journal

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“…Chorioamnionitis is a serious complication of pregnancy that is caused by bacterial infection or inflammation of the fetal amnion and chorionic membranes have been shown to be onset neonatal sepsis. Also velocities were higher in the case of sepsis-associated encephalopathy at newborns compared to group with neonatal sepsis and no encephalopathy (9).…”

Section: Introductionmentioning

confidence: 80%

“…The mean maternal age was 28±6.9 years. Median gravida was three (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). The mean gestational age at diagnosis of PPROM was 29±2.6 weeks.…”

Section: Resultsmentioning

confidence: 99%

“…Shimy et al reported higher blood flow velocities in cerebral arteries at newborns with neonatal sepsis and was associated with the severity of the disease (9). Fetal inflammatory response may be associated with higher velocities in blood flow that is remarked at newborns with neonatal sepsis but this association is not detected at clinical chorioamnionitis patients' fetuses.…”

Section: Discussionmentioning

confidence: 97%

See 1 more Smart Citation

Changes in Umbilical and Cerebral Blood Flow in Pregnancies Diagnosed with Clinical Chorioamnionitis. Is Chorioamnionitis Predictable?

Ozkan¹,

Ekmekçi²

2019

Gynecol Obstet Reprod Med

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Objective: To evaluate the predictability of clinical chorioamnionitis by Doppler changes in fetal middle cerebral and umbilical arteries, at hospitalized patients due to preterm premature rupture of membranes.Study Design: Patients who were admitted and hospitalized due to preterm premature rupture of membranes between 24 weeks and 33 weeks and 6 days pregnancies are included in the study. Demographic data of patients, gestational age at referring to hospitalization, fetal presentation at admission, delivery time, delivery indications and total follow-up time until delivery of each case were recorded.Results: A total of 108 patients were evaluated retrospectively. The rate of clinical chorioamnionitis was 5.55% (6/108). There was no significant difference between pregnancies terminated with the diagnosis of clinical chorioamnionitis and pregnancies terminated with other indications in terms of the maximum systolic velocity at middle cerebral artery and umbilical artery pulsatility indices.Conclusion: Clinical chorioamnionitis is a serious complication and is more common in patients being followed up after preterm premature rupture of membranes. Although it is crucial to be predicted due to neonatal worse prognosis, it cannot be predicted by middle cerebral and umbilical artery Doppler evaluation.

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“…Post mortem histology in humans who died from septic shock at the early stage of sepsis, indicate that the neuropathological alterations may be the starting point for permanent neurological damage in survivors, leading to long-term SAE -associated symptoms (4,5,16,(27)(28)(29). Early-onset neonatal sepsis can lead to an extremely complex set of events, like brain injury, and survivors remain vulnerable to both short-and long-term neurodevelopmental morbidity, due to long-term changes in cerebral blood flow, the release of neuroinflammatory proteins and altered metabolism (30).…”

mentioning

confidence: 99%

Insight Into Regulatory T Cells in Sepsis-Associated Encephalopathy

et al. 2022

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Sepsis-associated encephalopathy (SAE) is a diffuse central nervous system (CNS) dysfunction during sepsis, and is associated with increased mortality and poor outcomes in septic patients. Despite the high incidence and clinical relevance, the exact mechanisms driving SAE pathogenesis are not yet fully understood, and no specific therapeutic strategies are available. Regulatory T cells (Tregs) have a role in SAE pathogenesis, thought to be related with alleviation of sepsis-induced hyper-inflammation and immune responses, promotion of T helper (Th) 2 cells functional shift, neuroinflammation resolution, improvement of the blood-brain barrier (BBB) function, among others. Moreover, in a clinical point of view, these cells have the potential value of improving neurological and psychiatric/mental symptoms in SAE patients. This review aims to provide a general overview of SAE from its initial clinical presentation to long-term cognitive impairment and summarizes the main features of its pathogenesis. Additionally, a detailed overview on the main mechanisms by which Tregs may impact SAE pathogenesis is given. Finally, and considering that Tregs may be a novel target for immunomodulatory intervention in SAE, different therapeutic options, aiming to boost peripheral and brain infiltration of Tregs, are discussed.

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Cerebral blood flow and serum neuron-specific enolase in early-onset neonatal sepsis

Abstract: High CBF and cNSE could be useful markers for prediction of SAE. SAE impairs neurodevelopmental scales at 6 months.

Cited by 24 publications

References 39 publications

Efficacy of Cranial Doppler ultrasound in Diagnosis of Early-onset neonatal sepsis

Efficacy of Cranial Doppler ultrasound in Diagnosis of Early-onset neonatal sepsis

Changes in Umbilical and Cerebral Blood Flow in Pregnancies Diagnosed with Clinical Chorioamnionitis. Is Chorioamnionitis Predictable?

Insight Into Regulatory T Cells in Sepsis-Associated Encephalopathy

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