Glycemic Status and its Effect in Neonatal Sepsis in a Tertiary Care Hospital

Islam, Mohammad Saiful; Mia, Mohammad Abdul Hai; Akhter, Khandaker Rokshana; Haque, Mujibul; Malik, M. O. A.

doi:10.3329/bjch.v40i1.31551

Cited by 5 publications

(8 citation statements)

References 4 publications

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“…Similar indings was found on a Study done by Islam, et al [20], showing that mortality was higher among the septic newborn with hyperglycemia (50%) compared to normoglycaemic patient (10.8%) and the difference was statistically signi icant (p < 0.05) between two groups [20]. Yadav, et al found the incidence of culture positive sepsis was 6.5% of the total cases of suspected sepsis, which was much lower than the present study [21].…”

Section: Discussionsupporting

confidence: 90%

Glycemic status and its effect in Neonatal Sepsis - A prospective study in a Tertiary Care Hospital in Nepal

Gupta¹,

Gupta²,

Shrivastava³

et al. 2019

J Adv Pediatr Child Health

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Introduction: Sepsis is an important cause of morbidity and mortality among neonates. Neonatal sepsis can alter the glucose level and both hypoglycemia and hyperglycemia may occur. A high or low blood glucose level may have a signifi cant effect on the outcomes in patients of neonatal sepsis. Aims:The aim of the study to see the glycaemic status and its effect on outcome of neonatal sepsis. Material and Methods:This hospital based prospective observational cross-sectional study was conducted in Neonatal Intensive Care Unit in Universal College of Medical Sciences, a tertiary care hospital over a period of 4 months, from May 2019 to August 2019. A total of 220 Neonates suspected sepsis under the age of 28 days admitted in NICU, were studied and included in our study. Clinically suspected neonatal sepsis cases were enrolled in the study. Venous blood was collected before giving any intravenous fl uid, dextrose or antibiotics and blood sugar, complete blood counts, CRP levels and blood culture were send to laboratory within half hour of collection. All patients included in this study were treated accordingly and followed up strictly. Blood glucose level and mortality of neonates having hypoglycemia, hyperglycemia were analyzed among CRP and culture positive patients. Quantitative data were expressed as mean and standard deviation. Qualitative data were expressed as frequency and percentage and comparison carried by Chi-square (χ2) test.Results: A total of 220 patients clinically diagnosed as neonatal sepsis were studied. 118 (53.6%) patients were found CRP positive and 56 (25.5%) patients were blood culture positive. Glycaemic status was analyzed among CRP and culture positive patients. Majority (55.9%) patients were found normoglycemic, 35.5% were found hypoglycemic and 8.6% were found hyperglycaemic in this study. 182 (82.73%) patients were cured and 38 (17.27%) died. Mortality was high in hypoglycaemic patients (34.4%) compared with normoglycaemic patients (9.82%), but the difference was not statistically signifi cant (p > 0.05) between two groups, the mortality was high in hyperglycaemic patients (58.33%) compared with normoglycaemic patients (9.82%) and the difference was statistically signifi cant (p < 0.05) between two groups. Conclusion:Alteration of glycaemic status occurred in septic newborn. Mortality is higher among the septic newborn with hyperglycemia. The present study found that majority of neonate with sepsis had high mortality rate when blood glucose level were either more than 145 mg/dl or less than 45 mg/ dl. This signifi es the importance of meticulous blood glucose estimation in cases of neonatal sepsis to improve mortality outcome.

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Section: Discussionsupporting

confidence: 90%

Glycemic status and its effect in Neonatal Sepsis - A prospective study in a Tertiary Care Hospital in Nepal

Gupta¹,

Gupta²,

Shrivastava³

et al. 2019

J Adv Pediatr Child Health

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show abstract

“…In the study, the most abnormal sugar levels found in neonatal sepsis were hyperglycemia (51.6%), but mortality occurred more in hypoglycemia (RR 3.75 (95% CI 2.06 to 6.82) with p<0.001. Research by Islam et al (2016) found a similar result that the majority of abnormal blood sugar was hyperglycemia (15.3%) compared to hypoglycemia (13.45%). Mortality was more common in neonatal sepsis with hypoglycemia (42, 8%) compared to normoglycemia (10.8%) although not significantly significant (p> 0.05).…”

Section: Discussionmentioning

confidence: 68%

“…A state of severe acidosis can indirectly increase glycolysis and cause impaired cardiovascular function. Hypoxia that occurs also increases consumption of glucose, the combination of hypoglycemia and asphyxia increases mortality in neonatal sepsis [21][22][23].…”

Section: Discussionmentioning

confidence: 99%

Mortality of Neonatal Sepsis with Abnormal Blood Glucose Level

Adnyana¹,

Sanjaya²,

Sukmawati³

et al. 2021

AJP

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Sepsis is the third leading cause of death in neonates after asphyxia and low birth weight babies (LBW). Abnormal blood glucose, both hypoglycemia and hyperglycemia, were common metabolic changes in neonatal sepsis. This condition can higher the risk of morbidity and mortality in neonatal sepsis. The aim of this study is to prove the difference in mortality of neonatal sepsis with abnormal blood glucose compared to normal blood glucose. This was a cohort retrospective study with subjects were neonate with 28-42 weeks of gestational age with neonatal sepsis confirmed from clinical sign or blood culture at neonatal ward Sanglah hospital in the period January-August 2020. Subjects were classified as abnormal and normal blood glucose level. Chi-square test was used to assess the difference of mortality in blood glucose level. Multivariate analysis was performed with logistic regression. A total of 64 subjects with abnormal blood glucose and 64 subjects with normal blood glucose were included in this study. Mortality in subject with abnormal blood glucose was 50% and 17.2% with normal blood glucose (P<0,005). Multivariate analysis found abnormal blood glucose increases the risk of mortality 3,04 times compare with normal blood glucose (95% CI 1.09 to 8,45, P<0.033). Mechanical ventilation and asphyxia can also increase the risk of mortality in neonatal sepsis by 12,33 times (95% CI 3,99 to 38,07, P<0,001) and 8.17 times (95% CI 2,35 to 28,37, P<0,001) respectively. Subanalysis found hypoglycemia increases the risk of mortality 3.75 times compare to normoglycemia (95% CI 2.06 to 6.82, P<0.005), and hyperglycemia increases the risk of mortality 2.12 times compare to normoglycemia (95% CI 1.04 to 4.26, P=0.035). Conclusion there are significant difference of mortality in neonatal sepsis with abnormal blood glucose which is higher than normal blood glucose level. This research also found mechanical ventilation and asphyxia can effect the mortality in neonatal sepsis.

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“…The clinical features of neonatal sepsis are not feeding well, convulsions, fast breathing (>60 breath/min on the second count), severe chest indrawing, low body temperature (less than 35.5ºC or 95.9ºF), fever (more than 37.5ºC or 99.5ºF) (20) and movement only when stimulated or no movement at all. In the present study, among 39 (43.3%) subjects who had severe chest indrawing, 16 subjects had GRBS of 41 to 100.…”

Section: Discussionmentioning

confidence: 99%

A Cross-Sectional Study of Blood Glucose Levels in Neonatal Sepsis and its Outcome in a Tertiary Care Hospital, Davangere

Raj¹,

Aradhya²,

Raghoji³

2022

IJPCCR

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Sepsis is an important cause of morbidity and mortality among neonates. Neonatal sepsis can alter the glucose level, and both hypoglycaemia and hyperglycaemia may occur. Hence the present study aimed to study the clinical profile of patients with neonatal sepsis and to correlate the blood sugar levels with different outcomes in neonatal sepsis patients. A cross-sectional study was conducted at Bapuji Child Health Institute and Research Institute attached to J.J.M. Medical College, Davangere. A total of 90 neonates under the age of 28 days old admitted to NICU with probable and culture-proven neonatal sepsis were included in the study. Glucose levels, complete blood count, CRP levels, septic screening, lumbar puncture, neurosonogram, urine culture, blood culture and sensitivity were analysed. Results revealed that GRBS scores were < 40 for 24 subjects, 41 to 100 for 39 subjects, 101 to 200 for 22 subjects and > 200 for 5 subjects. There were 57(63.3%) males and 33(36.7%) females in the clinically diagnosed cases of septicemia. Clinical presentation in sepsis showed that 82(91.1%) subjects were not feeding well, 19(21.1%) had convulsions, 51(56.7%) had fast breathing, 39(43.3%) had Severe chest indrawing, 25(27.8%) had a temperature, 43(47.8%) had a fever and 88(97.8%) had Decreased activity of admission. In Conclusion, alteration of glycaemic status occurred in septic newborns, and mortality was higher among septic newborns with altered glycaemic status. Keywords: Neonatal sepsis, GRBS, Hypoglycaemia, Hyperglycaemia, Mortality

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Glycemic Status and its Effect in Neonatal Sepsis in a Tertiary Care Hospital

Cited by 5 publications

References 4 publications

Glycemic status and its effect in Neonatal Sepsis - A prospective study in a Tertiary Care Hospital in Nepal

Glycemic status and its effect in Neonatal Sepsis - A prospective study in a Tertiary Care Hospital in Nepal

Mortality of Neonatal Sepsis with Abnormal Blood Glucose Level

A Cross-Sectional Study of Blood Glucose Levels in Neonatal Sepsis and its Outcome in a Tertiary Care Hospital, Davangere

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