Plasma nitrite/nitrate and endothelin-1 concentrations in neonatal sepsis.
OBJECTIVE
To determine the changes in plasma nitrite/nitrate (NOx) and endothelin-1 (ET-1) concentrations during neonatal sepsis.


METHODS
In a prospective study, 60 consecutive newborns meeting the criteria for sepsis and without receiving exogenous nitric oxide (25 haemoculture-positive [HC+] and 35 haemoculture-negative [HC-]) were compared with 68 healthy newborns (46 full-term and 22 preterm). NOx and ET-1 concentrations were measured in each newborn within 48 h of diagnosis of sepsis and then every third day up to three determinations. SNAP-II and SNAPPE-II severity scores were performed at the moment of highest clinical severity.


RESULTS
At the beginning of the sepsis period, controls and septicaemic newborns had similar NOx and ET-1 levels, with the exception of infants with severe HC+ sepsis. Throughout the sepsis period, NOx increased in moderate HC+ sepsis and decreased in HC--sepsis, reaching a significant difference at the end of the study period (59.9 +/- 72.7 vs 33.9 15.3 micromol/L; p = 0.036). Meanwhile, ET-1 in newborns with severe HC+ sepsis remained higher than that in the moderate HC+ sepsis group and HC--group, reaching significant differences in all the periods. The highest ET-1 value was positively correlated with SNAP-II and SNAPPE-II scores.


CONCLUSIONS
NOx concentrations increased throughout the neonatal HC+ sepsis period, reaching significant differences after 7-9 d. The highest ET-1 levels in neonatal HC+ sepsis emerged before the NOx peak, at 3-5 d, and later decreased. Only newborns with severe HC+ sepsis presented a significant increase in ET-1 concentrations from the beginning of the septicaemic process.
Figueras-Aloy
J
J
Neonatal Service, Institut Clínic de Ginecologia, Obstetrícia i Neonatologia, Unitat Integrada de Pediatria, Barcelona, Spain. figueras@medicina.ub.es
Gómez
L
L
Rodríguez-Miguélez
J M
JM
Jordán
Y
Y
Salvia
M D
MD
Jiménez
W
W
Carbonell-Estrany
X
X
D001724:Birth Weight; D019332:Endothelin-1 / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009566:Nitrates / Q000097:blood*; D009573:Nitrites / Q000097:blood*; D011446:Prospective Studies; D018805:Sepsis / Q000097:blood* / Q000151:congenital*; D012720:Severity of Illness Index; D013997:Time Factors
D019332:Endothelin-1; D009566:Nitrates; D009573:Nitrites