The challenges of neonatal sepsis management

Procianoy, Renato S.; Silveira, Rita de Cássia dos Santos

doi:10.1016/j.jped.2019.10.004

Cited by 56 publications

(38 citation statements)

References 40 publications

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“…Sepsis remains the main cause of morbidity and mortality in clinic worldwide, mainly caused by immune response [21][22][23]. Various reports have highlighted that immune cells are involved in sepsis, including macrophage.…”

Section: Discussionmentioning

confidence: 99%

Expression and role of ABIN1 in sepsis: In vitro and in vivo studies

Sun

Meng

et al. 2020

Open Medicine

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In this research, we attempted to explain the effect and the related molecular mechanisms of ABIN1 in lipopolysaccharide (LPS)-induced septic mice or RAW264.7 macrophages. LPS was adopted to treat RAW264.7 macrophages for 4 h, and the levels of inflammatory factors were assessed by ELISA. Besides, ABIN1 expression was measured by quantitative reverse transcription polymerase chain reaction. Apparently, LPS enhanced immunoreaction, suggested by increased expression of IL-1β, tumor necrosis factor (TNF)-α, and IL-6. ABIN1 levels were obviously reduced compared to the control. Furthermore, we evaluated the roles of ABIN1-plasmid in immunoreaction and nuclear factor-κB (NF-κB) pathway. We found that ABIN1-plasmid significantly reduced the expression of IL-1β, TNF-α, and IL-6 in LPS-treated cells and inhibited NF-κB pathway activation. Meanwhile, a septic mouse mode was conducted to validate the role of ABIN1 in inflammatory response and organ damage in vivo. These data suggested that ABIN1-plasmid significantly inhibited the secretion of inflammatory cytokines and Cr, BUN, AST, and ALT levels in the serum of LPS-stimulated mice compared to LPS + control-plasmid group, reflecting the relieved inflammation and organ injury. In summary, the present findings indicated that ABIN1 alleviated sepsis by repressing inflammatory response through NF-κB signaling pathway, emphasizing the potential value of ABIN1 as therapeutic strategy for sepsis.

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Section: Discussionmentioning

confidence: 99%

Expression and role of ABIN1 in sepsis: In vitro and in vivo studies

Sun

Meng

et al. 2020

Open Medicine

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“…Outro fator relevante voltado para o âmbito primário diz respeito aos pré-natais efetivos, pois a faixa etária de neonatos compõe uma das que apresentam maior incidência (Dados do Observatório Mundial da Saúde, 2016), e estudos demonstram que complicações gestacionais tais como infecções, baixa adesão e periodicidade de consultas estão associados a partos com complicações, recém-nascidos pré-termo, baixo peso, e com maior permanência no hospital em unidades de terapia intensiva, e, portanto, maior exposição a procedimentos invasivos, entre outros desfechos desfavoráveis (Liang, 2018;Procianoy & Silveira, 2020;Lôbo et al, 2019).…”

Section: Discussionunclassified

Internamentos por septicemia nas capitais brasileiras, no período de 1999 a 2016 e a sua relação com o Índice de Desenvolvimento Humano

Rosário

Martins

Schwab

et al. 2021

RSD

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Objetivos: demonstrar a série histórica de internamentos por sepse no Brasil, quais as capitais e regiões mais acometidas, bem como, se essas internações tiveram crescimento, em que proporção ocorreram e qual a relação com o Índice de Desenvolvimento Humano (IDH). Métodos: Foi realizado um estudo epidemiológico de série temporal com dados dos internamentos por septicemia nas capitais brasileiras de 1999 a 2016, obtidos do Sistema de Informações Hospitalares do Ministério da Saúde (SIH) e IDH das mesmas no período. Foram calculados os indicadores de internamentos para a metade de cada triênio do período obtido. Modelos de regressão linear e de Poisson foram realizados para verificar a tendência temporal e coeficientes de correlação de Pearson ou Spearman para correlação com o IDH. Resultados: houve aumento significativo de internamentos em algumas capitais, tais como: Boa Vista, Maceió, Porto Velho e Rio de Janeiro, e decréscimo em Campo Grande e Goiânia. A maior média de internamentos ocorreu em Porto Velho com 26.443,7 e a menor média em Teresina 171,3. Os coeficientes de correlação entre o total de internamentos e o IDH de cada capital registraram correlação positiva e significativa para Belo Horizonte, Boa Vista, São Paulo e Vitória. Conclusão: os internamentos por sepse tiveram mais acréscimos que decréscimos e a correlação com o IDH mostrou que quanto maior o IDH, maior fica o índice de internamentos, sugerindo que com taxas maiores desse IDH, torna-se possível fornecer uma estrutura adequada e um melhor desempenho no reconhecimento e desfecho da sepse.

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“…LOI poses challenges for homeostatic control systems of major body functions (18), and a number of physiological signs and clinical symptoms are evident in neonates with LOI. These are used in clinical settings to instigate treatment for suspected infection (31)(32)(33). It has been suggested by the World Health Organization (WHO) that neonatal sepsis should be confirmed by evidence from at least two laboratory tests and at least two clinical symptoms in the case of suspected or proven infection (34).…”

Section: Preterm Infantsmentioning

confidence: 99%

“…It has been suggested by the World Health Organization (WHO) that neonatal sepsis should be confirmed by evidence from at least two laboratory tests and at least two clinical symptoms in the case of suspected or proven infection (34). There is worldwide consensus that clinical disturbances associated with LOI include hypotension, temperature instability, apnea, respiratory distress, tachy/bradycardia, and gastrointestinal problems (18,33). Laboratory criteria include high immature-to-total neutrophil ratio, low platelet count, high/low white blood cell counts, hypoglycemia/hyperglycemia, metabolic acidosis [base excess (less than À10 mEq/L) or an elevated serum lactate (>2 mmol/L)] (32,35).…”

Section: Preterm Infantsmentioning

confidence: 99%

Influence of innate immune activation on endocrine and metabolic pathways in infancy

O’Connor

Ashoori

Dias

et al. 2021

American Journal of Physiology-Endocrinology and Metabolism

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Prematurity is the leading cause of neonatal morbidity and mortality worldwide. Premature infants often require extended hospital stays, with increased risk of developing infection compared with term infants. A picture is emerging of wide-ranging deleterious consequences resulting from innate immune system activation in the newborn infant. Those who survive infection have been exposed to a stimulus that can impose long-lasting alterations into later life. In this review, we discuss sepsis-driven alterations in integrated neuroendocrine and metabolic pathways and highlight current knowledge gaps in respect of neonatal sepsis. We review established biomarkers for sepsis and extend the discussion to examine emerging findings from human and animal models of neonatal sepsis that propose novel biomarkers for early identification of sepsis. Future research in this area is required to establish a greater understanding of the distinct neonatal signature of early and late-stage infection, to improve diagnosis, curtail inappropriate antibiotic use and promote precision medicine through a biomarker-guided empirical and adjunctive treatment approach for neonatal sepsis. There is an unmet clinical need to decrease sepsis-induced morbidity in neonates, to limit and prevent adverse consequences in later life and decrease mortality.

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The challenges of neonatal sepsis management

Cited by 56 publications

References 40 publications

Expression and role of ABIN1 in sepsis: In vitro and in vivo studies

Expression and role of ABIN1 in sepsis: In vitro and in vivo studies

Internamentos por septicemia nas capitais brasileiras, no período de 1999 a 2016 e a sua relação com o Índice de Desenvolvimento Humano

Influence of innate immune activation on endocrine and metabolic pathways in infancy

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