Base excess as a predictor of neonatal mortality in neonatal sepsis

Authors

  • Sushrutha K. P. Department of Pediatrics, Chamarajanagara Institute of Medical Sciences, Chamarajanagara, Karnataka, India
  • Hamsa Department of Pediatrics, Chamarajanagara Institute of Medical Sciences, Chamarajanagara, Karnataka, India
  • Lingaraju N. Department of ENT, Chamarajanagara Institute of Medical Sciences, Chamarajanagara, Karnataka, India
  • Sampath Kumar C. Department of Pediatrics, DEIC, Mysore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20233603

Keywords:

Neonatal sepsis, Base excess, Neonatal mortality

Abstract

Background: Neonatal sepsis is responsible for approximately 15% of all neonatal deaths in the world. Despite of availability in advanced medical healthcare facilities for mother and neonates, incidence of mortality secondary to sepsis especially in developing countries like India is more common. Metabolic acidosis is the most common form of acid base imbalance in neonatal sepsis which can be analyzed with increased levels of base excess. Hence early diagnosis of neonatal sepsis can be done by determining base excess.

Methods: This is a prospective observational study conducted in NICU at Cheluvamba Hospital, Mysore. 73 term neonates with suspected sepsis were enrolled in the study who were on regular follow-up and treatment till death/discharged from NICU. Base excess value is obtained from the arterial blood gas analysis from each subject and it was compared with survivor and non-survivor group along with other study parameter

Results: Out of 73 subjects, incidence of non survivors group with severe increase in base excess is 75%. To predict the mortality, we compared it with standard base excess which showed the prediction of more than 60%, with significant AOC (0.827) of very near to one in ROC curve, with statistically significant (p<0.001) sensitivity of 92.59%, specificity of 63.04%, positive predictive value of 59.5%, negative predictive value of 93.5%.

Conclusions: In present study we have proved that base excess is an important parameter for the early diagnosis and for early intervention in neonatal sepsis.

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References

Sperling MA, Kliegman RM, Geme JW, Blum NJ, Shah SS, Tasker RC, et al. The Neonate Infant. In: Nelson textbook of Paediatrics. 21st ed. Philadelphia: Elsevier; 2020:996-1000.

Liu L, Oza S, Hogan D, Chu Y, Perin J, Zhu J, et al. Global, regional and national causes of under-5 mortality in 2000-15: an updated systematic analysis with implications for the sustainable development goals. Lancet. 2016;388(10063):3027-35.

Investigators of the Delhi Neonatal Infection Study (DeNIS) collaboration. Characterization and antimicrobial resistance of sepsis pathogens in neonates born in tertiary care centers in Delhi, India: a cohort study. Lancet Glob Health. 2016;e752-60.

National Neonatal Perinatal Database; Report. Available at: https://www.newbornwhocc.org/ pdf/HRRC-Report_2002-03.pdf. Accessed on 20 February 2023.

Dhaded SM, Somannavar MS, Moore JL, Elizebath M, McClure, Sunil S, et al. Neonatal deaths in rural Karnataka, India 2014-2018: A prospective populationbased observational study in a low resource setting. Reprod Health. 2020;17:161.

West BA, Tabansi PN, Ugwu RO, Eneh AU. The predictive value of micro erythrocyte sedimentation rate in neonatal sepsis in a low resource country. Pediatr Therap. 2012;2:21-9.

Vinay BS, Girish GN, Adhikari S, Hugara S. Evaluation of septic screen as a diagnostic tool for neonatal sepsis in a tertiary hospital at Mysore. Schol J Appl Med Sci. 2015;3(2):1005-10.

Arayici S, Simsek GK, Canpolat FE, Oncel MY, Uraş N, Oguz SS. Can base excess be used for prediction to early diagnosis of neonatal sepsis in preterm neonates? Mediterr J Hematol Infect Dis. 2019;11(1):e201.

Yusuf MM, Chowdhury MAK. Correlation of blood gas status with the mortality of neonates admitted in ICU in the year 2014. North Int Med Coll J. 2017; 9(1):261-3.

Ahmad I, Ahmed A, Roy S. Acid base disorders in critically ill neonatal intensive care patients and predicting survival by the presence of deranged acid-base variables. J Neonatal Biol. 2015;5:207.

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Published

2023-11-27

How to Cite

K. P., S., M. , H., N., L., & C. , S. K. (2023). Base excess as a predictor of neonatal mortality in neonatal sepsis. International Journal of Contemporary Pediatrics, 10(12), 1819–1823. https://doi.org/10.18203/2349-3291.ijcp20233603

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Original Research Articles