Sterile Inflammation

Dr Nalinikant PanigrahyMD , DNB Neonatology

Consultant Neonatology

Inflammation: What Is It?

An adaptive response to restore homeostasis

Physiologic Inflammation is Central to Reproductive Success

Culture-Negative Early-Onset Neonatal Sepsis — At the Crossroad Between Efficient Sepsis Care and Antimicrobial Stewardship Frontiers of pediatrics ,2018

Two summaries1. Respect Blood culture -

Negative report2. Robust definition of sepsis

INFLAMMATION is NOT INFECTION

Chorioamnitis

• Hypoxia –Ischemia • Preterm delivery • IUGR

Placental swab negative Placenta biopsy – No infectionHigh TLC count Increased other inflammatory markers

Blood Culture Negative High count TLC , Increased CRP = persistent high CRP even after antibiotics

107 VLBW cases = 15 babies CMV= 03 babies Fungal after 2nd Culture = 09 Babies CMPI

Unpublished Unit auditing

Inflammasomes – Pandora Box ?

DAMP PAMP

Latest Research

Summary

• Early suspicion of Sterile inflammation

• Respecting Blood culture negative Reports , Sepsis marker positive cases

• Prevention of inflammation if possible

• Newer treatment modalities