الفهرس 
Review of literatureOnly 14 pages are availabe for public view
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Abstract
Infection is one of the major problems in neonates. The diagnosis of neonatal septicemia is difficult to establish based on the clinical criteria alone. However, empirical treatment should not be delayed because of the high mortality.
Neonates with sepsis can present with respiratory distress, poor cry, poor sucking, reluctance or inability to take feed, lethargy, hypothermia, vomiting, and diarrhea. Some of these manifestations can lead to fluid and electrolyte abnormalities.
Moreover, many neonates admitted in NICU (Neonatal Intensive Care Unit) require intravenous fluids. Inadequate fluid intake can lead to dehydration, hyperosmolarity, and renal failure; while excessive fluid administration may result in generalized edema, impairment of pulmonary function, patent ductus arteriosus, congestive cardiac failure, intraventricular hemorrhage, and bronchopulmonary dysplasia. The changes in mechanism of homeostasis in early days of life are an important aspect of neonatal life, and kidney plays a vital role in this process.
Besides the above mentioned problems, inadequate or excessive intake of fluids, less than optimum or excessive intake of electrolytes and abnormalities in the loss of electrolyte scan lead to abnormal levels of electrolytes in the blood. Consequently, fluid and electrolyte management are an important aspect in the treatment of neonatal sepsis. Studies have shown that among the neonates admitted in NICU (Neonatal Intensive Care Unit), different electrolyte abnormalities like hyponatremia and hypocalcemia are associated with increased mortality.
In addition, laboratory tests used to support diagnosis have shown variable predictive values. C-reactive protein (CRP), an acute phase protein, increases in inflammatory disorders and tissue injury. Serial CRP measures have been shown to be more useful than a single measured CRP in the diagnostic evaluation of neonates with suspected infection.
We aimed to study the value of serial CRP and some serum electrolytes in neonatal septicemia.
In our study we have 200 neonates (100 case and 100 control)
All subjected tohistory taking, complete general and systemic examination and laboratory investigations were done to all of them.
Our results relieved that:
There was high statistically significant difference between cases and control as regards hematological score and sepsis score. There was no statistically significant difference between them and Ballard score.
There was high statistically significant association between neonates with sepsis and CRP after 2 days, CRP after 4 days, CRP after 6 days CRP after 8 days and CRP after 10 days
There was statistically significant difference between sepsis onset and CRP serial in neonate with sepsis at admission only.
There was statistically significant correlation between CRP and WBS, platelets, k, Ca and hematological score at admission.
Summary
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Roc curve of CRP at admission at cut off point ≥18 has 91.4% sensitivity, 40% specificity, 60 % positive predictive value and 83% negative predictive value, with area under the curve (AUC=0.81).
Roc curve of CRP after 48 hours at cut off point ≥36 has 75% sensitivity , 77% specificity, 77 % positive predictive value and 75% negative predictive value, with area under the curve(AUC=0.73). while CRP after 4 days at cut off point ≥18 has 87% sensitivity , 62% specificity, 70 % positive predictive value and 83% negative predictive value, with area under the curve(AUC=0.79).
There was high statistically significant association between as regards CRP at admission, CRP after 48 hours, CRP after 4 days, CRP after 6 days. There was statistically significant difference between survive and died patients as regards CRP after 8 days and CRP after 10 days.