CHARACTERISTICS OF MULTISYSTEM ORGAN FAILURE IN NEONATES

The records of 45 neonatal deaths in a four year period were reviewed retrospectively. Sixteen patients (35.5%) developed multisystem organ failure (MSOF). The criteria for pulmonary, hepatic, renal, hematologi c, cardiac and microvascular failures were established. The onset of t he first organ involvement was calculated in days prior to death. The earliest organ involved was kidney (14.2 +/- 15.1) followed by microva scular (9.4 +/- 7.6), hematologic (8.4 +/- 10.1), liver (6.8 +/- 6.7), lung (6.3 +/- 6.6) and cardiac (6.0 +/- 8.7) failure. Blood culture a nalyses revealed 5 patients with culture-positive sepsis. Yeast was th e leading septic agent (n = 3) followed by Klebsiella pneumoniae (n = 2), Pseudomonas sp. (n = 1) and E. coli (n = 1). The first organ invol vement was noted at 17.6 +/- 23.2 days. We concluded that the sequence of neonatal MSOF is different from that of adults, yet the inciting e vents are not clear-cut. Lung, which is the first organ involved in ad ults, seems to be a lately involved organ in neonates.