Impact of Sepsis on Neurodevelopmental Outcome in a Swiss National Cohort of Extremely Premature Infants

Abstract

Proven sepsis significantly contributes to NDI in extremely preterm infants, independent of other risk factors. Better strategies aimed at reducing the incidence of sepsis in this highly vulnerable population are needed.

Brain MRI Measurements at a Term-Equivalent Age and Their Relationship to Neurodevelopmental Outcomes

“…Abnormalities of the cerebellum in mice after exposure to phenobarbital, such as a decrease in the number of Purkinje 37 and granular cells, 33 without an effect on the area of the cerebellum, have been reported. Sepsis, an independent risk factor for a poor neurologic outcome, 25,34,38 could have exerted a detrimental effect on the growth of the cerebellum by diffuse white matter injury, 24 bacterial products and cytokines, 39,40 arterial hypotension, and combined cerebral ischemia. 25 Bronchopulmonary dysplasia, a known risk factor for neurodevelopmental impairment, has also been reported to exert an effect on the granular cells of the cerebellum, as shown in a baboon model.…”

The CD95/CD95L pathway is involved in phagocytosis-induced cell death of monocytes and may account for sustained inflammation in neonates

“…Moreover, clinical, histological, and experimental data on diseases exclusively manifesting during the neonatal period, such as bronchopulmonary dysplasia (3,6,31) and periventricular leukomalacia (4,7,32), are all linked to prolonged inflammation leading to tissue destruction. Thus, the data presented here might contribute to a molecular explanation for the "sustained inflammation" seen in neonates.…”

“…Although acute bacterial infection can be controlled in many cases, the accompanying inflammatory reaction, sometimes starting before birth, may be excessive and hardly controllable (3). Inflammation may even persist after resolution of infection, because sepsis predisposes to inflammatory diseases exclusively manifesting during the neonatal period, i.e., bronchopulmonary dysplasia and periventricular leukomalacia (2,(4)(5)(6)(7). As for this, Dammann et al coined the term "sustained inflammation" to describe a prolonged inflammatory reaction after an initial activation of the neonatal immune system, with an inability to resolve the resultant inflammation (8,9).…”

Chlorhexidine Bathing in a Tertiary Care Neonatal Intensive Care Unit: Impact on Central Line–Associated Bloodstream Infections

“…15 Given these data and because of high of age (95% confidence interval [CI], 1.9-16.7). 5 CLABSI incidence rates in our NICU, our CLABSI prevention Central line-associated bloodstream infections (CLABSIs) team implemented CHG bathing for a subgroup of infants are an important cause of morbidity and mortality in neowith central venous catheters (CVCs) as part of routine care. nates.…”