Comparing the Values of Serum High Density Lipoprotein (Hdl) Level in Neonatal Sepsis

Abstract

BACKGROUND Despite many years of intensive research, attempts to improve the outcome of sepsis and septic shock by modulating the inflammatory response have met with only limited success. This is at least in part a consequence of our limited understanding of the extremely complex mechanisms that regulate the inflammatory response. The development of successful treatments for sepsis and septic shock is, therefore, likely to require further improvements in our understanding of the factors that determine whether an individual responds appropriately to an infectious insult or progresses to uncontrolled systemic inflammation, immune compromise, and organ failure. In recent years, there has been a considerable interest in the ability of high-density lipoproteins (HDLs) to modulate the inflammatory response to sepsis, haemorrhagic shock, and ischemia-reperfusion injury and, hence, in their potential as novel therapeutic agents in these conditions. In this study, our objectives are measurement of normal HDL level, and evaluation of its variation in septic neonates to determine its prognostic and therapeutic values in this group of patients. METHODS In a descriptive-cross sectional study, 125 normal non-septic neonates and 50 CRP & blood culture positive septic neonates' serum HDL were analysed and compared. Results were analysed by SPSS Ver. 16 and ANOVA and Tukey tests. There was statistically significant difference in HDL level between normal and septic neonates. This study conducted in Mofid and Mahdiye Educational Hospital of Shahid Beheshti University over a period of 2 years. RESULTS First one hundred normal neonates' HDL was assessed and analysed to determine the normal serum level of HDL. After that, seventy-five neonates in 3 groups: 1-25 aseptic neonates, 2-25 septic CRP positive neonates and 3-25 septic blood culture positive neonates' HDL were assessed and analysed. Three group had no significant difference in general parameters such as gestational age, birth weight, Apgar scoring and many of hematologic and biochemical in parameters. But difference in HDL level, band cell count, CRP level, hospital stay and mortality were statistically significant (p value<0.001). CONCLUSIONS HDL decreased in septic neonates and in future it may be used as a new therapeutic modality.