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Role of Serial C‐Reactive Protein in Determining Duration of Antibiotic Use for Neonates with Suspected Neonatal Sepsis: A Randomised Controlled Trial
Author(s) -
Fareena Ahamed
Publication year - 2018
Publication title -
journal of paediatrics and child health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.631
H-Index - 76
eISSN - 1440-1754
pISSN - 1034-4810
DOI - 10.1111/jpc.13882_195
Subject(s) - medicine , neonatal sepsis , sepsis , randomized controlled trial , antibiotics , c reactive protein , pediatrics , intensive care medicine , inflammation , microbiology and biotechnology , biology
Australia Email: y.eiby@uq.edu.au Background: Preterm infants often have poor cardiovascular function and this is associated with adverse neurodevelopmental outcomes. This study aimed to determine if the current first-line treatment for poor cardiovascular function, volume expansion using saline, effectively treats hypotension. Methods: Over a 4h period, hypotensive (mean arterial pressure <27mmHg for >5min) preterm piglets (97/115d gestation) received either isotonic saline (10mL/kg i.v. over 30min) up to three times if hypotension persisted (n=4) or no treatment (n=3). MAP and arterial blood gas parameters were monitored at baseline and throughout the 4h of treatment. Results: At baseline, MAP was similar in the saline treated and untreated groups (24.7 2.1 vs 22.9 3.6mmHg) as was arterial pH (7.60 0.16 vs 7.63 0.16) and arterial base excess (2.72 3.5 vs 3.90 5.46mmol/L). All piglets in the treatment group required the 3 doses of saline. Saline treatment resulted in significantly lower MAP at the end of the 4h treatment period (16.0 4.1 vs 27.8 8.2mmHg), lower arterial base excess (-14.0 11 vs 3.3 3.5mmol/L), and lower pH (7.02 0.28 vs 7.43 0.35) compared with untreated piglets. Conclusions: Volume expansion with saline is ineffective at providing cardiovascular support in preterm neonates. More effective treatments are required to support cardiovascular function and reduce brain injury in preterm neonates.