Urinary nitric oxide in newborns with sepsis: a useful follow-up marker

Abstract

Neonatal Sepsis is a major problem in newborn nurseries because of the difficulty of early diagnosis and because of high morbidity and mortality. The objective of this study was to investigate whether urinary nitric oxide (NO) level could be useful for the diagnosis and follow-up of infected newborns. Urinary NO was measured for 30 newborns with sepsis on the first and on the fourth day (group I) and compared with 10 age-matched healthy control (group II). Ninety percent of the septic group showed increase in the urinary NO level during sepsis, while there was decrease in the NO level in the control group. The levels of NO did not differ significantly between cases and control on the first day (p = 0.24), but the difference was significant between the two groups on day 4 (p = 0.02). On comparing the change in NO level from first to fourth day between the two groups, a statistically significant difference was found (p = 0.000). Although urinary NO levels were higher in the infected newborns as compared to the controls on the fourth day, its failure to rise to statistically significant levels on day 1 makes it a nonsuitable marker for early diagnosis of neonatal sepsis, it can however be used for monitoring infection due to its rising level and ease of sample collection.