The specificity of nitric oxide in differentiating necrotizing enterocolitis from sepsis in full- term infants: a case-control study.

Abstract

Purpose of the study. The aim of the study is to identify the diagnostic capability of biomarkers – Nitric Oxide (NO), Erythropoietin (EPO) and Calcium ion (Са+2) in differentiating NEC from Sepsis in full-term newborns. Material/patients. A prospective case-control study was conducted in the intensive care and in the full-term neonatal pathology units of the Scientific Research Institute of Pediatrics named after K.Y. Farajova – Baku, Azerbaijan. The study included infants with a gestational age of 37≤ weeks. Demographic and clinical data were collected from patients with abdominal and systemic symptoms, associated with NEC. To conduct differential diagnosis of NEC from NEC + Sepsis, we chose NO, EPO and Ca+2 as potential biomarkers. ROC-curve analysis was used to calculate the diagnostic capability of these biomarkers. Results. We examined 100 full-term sick newborns with NEC. The weight of the children ranged between 2500 and 4400 grams. The levels of NO, EPO and Ca+2 were determined in the blood of all newborns in our sample. Elevated levels of NO, EPO and decreased levels of Ca+2 were observed in 83 patients. Whereas in 17 patients with NEC + Sepsis, that is, with septic complication of the disease, the test results obtained were opposite to those of the other group (p <0.001). Levels of NO in the patients with septic complication were even lower than the patients diagnosed with NEC I. Conclusions. Therefore, NO can be used as a biomarker for differential diagnosis of NEC from Sepsis.