A Study of Prothrombin Time, Thrombin Time, Fibrinogen and Vitamin K Levels in Sudanese Neonates with Proven Sepsis
Albara Ahmed, Abozer Y Elderdery, Babiker A Mohammed, Mohammed E Adam, Hasan Ejaz
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ABSTRACT
Aim: This study aims to assess
Prothrombin Time (PT), Thrombin Time (TT), fibrinogen and Vitamin K levels in
Sudanese neonates with sepsis. It also aims to correlate those parameters with
outcome, sepsis onset, and etiologic agent in the case group.
Methods: The study was done in Omdurman maternity
hospital from June 2013 to April 2015 on a total of 100 neonates divided
equally into case (neonates with proven sepsis) and control (healthy neonates).
PT was assessed by measuring the clotting time needed by the plasma after
calcified thromboplastin was added, expressed in seconds. TT was also assessed
by the clotting procedure after thrombin was added to plasma, also expressed in
seconds. Fibrinogen was assessed using the Clauss method, using 1/20 diluted
plasma then counting clotting time after thrombin was added, with results
obtained in mg/dl. Vitamin K was assessed using high-performance liquid
chromatography (HPLC) after plasma was prepared, extracted, injected into HPLC
system, separated using C-18, then reduced by the zinc in the post-column reduction
reactor then assessed by fluorescent detector, the result expressed in ng/ml.
Results: Among the case group; neonates who died
constituted 10 (20%), with 40 recovered (80%). PT was significantly prolonged
in septic neonates compared to the healthy ones (p value 0.01). Early sepsis neonates showed significant
prolongation in both PT and TT compared to the late onset neonates (p value 0.02 and 0.00). Fibrinogen showed significant increase
in septic neonates compared to healthy one (p value 0.00). Vitamin K didn’t show significant decrease in
septic neonates compared to the control. None of the outcome, onset of sepsis
and etiologic agent of sepsis showed significant correlation with fibrinogen or
Vitamin K.
Conclusion: In
concordance with our findings, sepsis leads to coagulopathy and thus the
morbidity and mortality rates could increase among neonates with sepsis.
Involvement of coagulation evaluation in sepsis can be beneficial in diagnosis
and management of septic cases
Keywords: Neonatal
sepsis, Fibrinogen, Prothrombin time, Thrombin time, Vitamin K, Mortality,
Sudan