Effect of pentoxifylline on sepsis and protein C level in preterm neonates / Shahenda Abdelaziz Khairy Mohamed ; Supervised Dahlia Bayoumi Elsebaie , Yasmeen Amr Mansi , Angie Mohamed Samir Tosson

Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Pediatrics

Background: Neonatal sepsis is almost invariably associated with pathological activation of the coagulation system, which in turn leads to microcirculatory derangement and multiple organ dysfunction syndrome (MODS). The key role in the pathogenesis of sepsis has been attributed to pro-inflammatory cytokines which trigger the development of disseminated intravascular coagulation (DIC). Pentoxifylline (PTX), a methylxanthine derivative, has the potential to modify inflammatory response via decreasing the inflammatory cytokines like tumor necrosis factor alpha, (TNF-Ü) and interleukin (IL-6). It is also used in peripheral vascular disease, and was found to enhance protein C system when given to septic adults. This work aim was to evaluate the potential effect of pentoxifylline on protein C in septic preterm neonates, and its effect on their clinical outcome, morbidity and mortality. Subjects and methods: This double blind randomized controlled trial included 80 preterm with clinical or culture proven late onset sepsis (LOS), with gestational ages <36 weeks and ages ranging from 3 to 28 days of life, Randomized into 2 groups the PTX group received pentoxifylline 5mg/kg/hr/6hrs for 6 successive days, while the control group received normal saline as a placebo, Protein C levels were measured before and after the intervention, and the short term morbidities and mortality was documented

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