Abstract
Introduction: To evaluate variations in platelet count and platelet indices- mean platelet volume (MPV) and platelet distribution width (PDW) in neonatal sepsis. Methodology: This study was conducted over a period of one year in Neonatal Intensive Care Unit of Mata Chanan Devi Hospital, New Delhi. Neonates with confirmed as well as probable sepsis were included in the study. Platelet count, MPV and PDW were monitored three times: at diagnosis (1st day), 3rd day and 7th day of sepsis. Results: Among 100 cases, culture proven sepsis was present in17 neonates. Fungal sepsis occurred in 2 cases (11.76%), 7 neonates (41.18%) had gram positive sepsis and 8 neonates (47.06%) had gram negative sepsis. Thrombocytopenia was present in 38% and thrombocytosis in 6% cases. Mild thrombocytopenia was noted in 55.26%, moderate thrombocytopenia in 31.58% and severe thrombocytopenia in 13.16% babies. Culture positive neonates had high prevalence of thrombocytopenia. High mortality was found in moderate to severe thrombocytopenic neonates, and these babies also had high MPV and high PDW. Conclusions: Thrombocytopenia was more common than thrombocytosis in neonatal sepsis. Prevalence of thrombocytopenia was significantly high in culture proven sepsis (64.7%). There was statistically significant difference in mean platelet count on day 1, day 3 and day 7 of sepsis among culture positive and culture negative neonatal sepsis. Neonates with culture proven sepsis had high MPV on day 7 and high PDW on day 1 of sepsis. There was high MPV and high PDW in neonates who developed thrombocytopenia and also in expired babies. Platelet count and platelet indices can be used as early diagnostic and prognostic biomarkers for neonatal sepsis.
Highlights
To evaluate variations in platelet count and platelet indices- mean platelet volume (MPV) and platelet distribution width (PDW) in neonatal sepsis
Thrombocytopenia was present in 38% cases, thrombocytosis was found in 6% cases and 56% cases had the normal platelet count
Thrombocytopenia is a common complication in neonatal sepsis and means platelet count improves over 7 days as sepsis gets controlled
Summary
To evaluate variations in platelet count and platelet indices- mean platelet volume (MPV) and platelet distribution width (PDW) in neonatal sepsis. MPV and PDW were monitored three times: at diagnosis (1st day), 3rd day and 7th day of sepsis. Results: Among 100 cases, culture proven sepsis was present in neonates. High mortality was found in moderate to severe thrombocytopenic neonates, and these babies had high MPV and high PDW. Prevalence of thrombocytopenia was significantly high in culture proven sepsis (64.7%). Neonates with culture proven sepsis had high MPV on day 7 and high PDW on day 1 of sepsis. There was high MPV and high PDW in neonates who developed thrombocytopenia and in expired babies. More than one-third of the estimated 4 million neonatal deaths around the world each year are caused by severe infections and a quarter (around one million deaths) are due to neonatal sepsis/ pneumonia alone [7]. Incidence is not changed much over the past decade, and the fatality due to sepsis is between 30% and 65% [10]
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