Document Detail

Hyperbilirubinemia in infants with Gram-negative sepsis does not affect mortality.
MedLine Citation:
PMID:  21543167     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Sepsis is associated with an increased production of oxidant species and a decrease in endogenous antioxidant defenses. Mortality is high, especially when endotoxins are involved, e.g., in infants with Gram-negative sepsis. Yet, chronic as well as acute unconjugated hyperbilirubinemia has been shown to protect against endotoxin-induced shock in vivo in rats and in mice. We hypothesized that hyperbilirubinemia in infants with Gram-negative sepsis improves survival and/or mitigates the inflammatory response.
OBJECTIVE: To assess the relationships between serum bilirubin concentrations on the one hand, and leukocyte count, C-reactive protein and survival on the other hand, in infants with Gram-negative sepsis.
METHODS: Retrospectively, we retrieved clinical and biochemical data from infants less than 90 days of age with a blood culture-proven Gram-negative sepsis between January 1998 and December 2005.
RESULTS: We identified 92 infants with Gram-negative sepsis in the indicated period. Median gestational age was 29 (24-42) weeks. 22 Patients died. Preceding sepsis, median total serum bilirubin concentrations were below 150 μmol/L. Median concentrations of conjugated bilirubin concentrations increased (+63%, p<0.05), and median concentrations of unconjugated bilirubin decreased (-36%, p<0.05) in infants with Gram-negative sepsis. Median total bilirubin concentrations before and during sepsis were not significantly different between survivors and non-survivors. Changes in bilirubin concentrations were not significantly correlated with changes in either white blood cell count or C-reactive protein.
CONCLUSION: Present data do not support the concept that bilirubin positively affects survival or the inflammatory response in infants with Gram-negative sepsis.
Paul van den Broek; Henkjan J Verkade; Christian V Hulzebos
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Publication Detail:
Type:  Journal Article     Date:  2011-05-04
Journal Detail:
Title:  Early human development     Volume:  87     ISSN:  1872-6232     ISO Abbreviation:  Early Hum. Dev.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-07-20     Completed Date:  2011-11-15     Revised Date:  2014-03-31    
Medline Journal Info:
Nlm Unique ID:  7708381     Medline TA:  Early Hum Dev     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  515-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Ltd. All rights reserved.
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MeSH Terms
Bacteremia / complications*,  mortality
Gestational Age
Gram-Negative Bacterial Infections / complications*,  mortality
Hyperbilirubinemia, Neonatal / complications*,  mortality
Infant Mortality
Infant, Newborn
Infant, Premature*
Infant, Premature, Diseases / mortality*
Retrospective Studies
Comment In:
Early Hum Dev. 2013 Oct;89(10):847   [PMID:  23910575 ]
Early Hum Dev. 2013 Oct;89(10):849   [PMID:  23910577 ]

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