The Efficacy of Melatonin in Neonatal Sepsis with Respiratory Distress: A Randomized Controlled Study

Authors

  • Dwi Hidayah Department of Pediatric, Faculty of Medicine, Universitas Sebelas Maret
  • Nur Irfani Agita Universitas Sebelas Maret Hospital, Indonesia

DOI:

https://doi.org/10.26911/thejmch.2024.09.05.03

Abstract

Background: Neonatal sepsis is a significant condition worldwide, contributing to high morbidity and mortality, especially in developing countries such as Indonesia. Neonatal sepsis can rapidly progress to respiratory distress. Melatonin, an effective antioxidant and free radical scavenger, may be an adjuvant therapy. This study aimed to evaluate the efficacy of melatonin in neonatal sepsis with respiratory distress.

Subjects and Method: A double-blind randomized controlled study was conducted on 42 neonatal sepsis with respiratory distress diagnosed with clinical and laboratory criteria. The subjects were randomly allocated into treatment and control groups, receiving a single dose of oral melatonin 20 mg and a placebo, respectively. The dependent variables were improvement of suplementation in oxygenation and ventilator, outcome, and hospital length of stay. The independent variables was suplementation melatonin The oxygen supplementation and ventilation support were measured at baseline and 72 hours after therapy. We analyzed all data with SPSS 25 using independent t test and determined the significance level at p < 0.050.             

Results: Seven of the 21 subjects in the treatment group experienced decreased oxygen supplemen­tation and ventilation support, which was statistically significant (p = 0.009). While the outcome for both groups was the same proportion, it was statistically not significant (p = 1.000).

Conclusion: Melatonin administration significantly decreased oxygen supplementation and ventilation support.

Keywords:

melatonin, neonatal sepsis, respiratory distress

Author Biography

Dwi Hidayah, Department of Pediatric, Faculty of Medicine, Universitas Sebelas Maret

Department of Child Health, Universitas Sebelas Maret Medical School/Dr. Moewardi Hospital, Surakarta, Central Java

References

Cannavò L, Perrone S, Marseglia L, Viola V, Di Rosa G, Gitto E (2021). Potential benefits of melatonin to control pain in ventilated preterm newborns: An updated review. Pain Pract. 22(2):248-254. doi: 10.1111/papr.13069.

D'Angelo G, Chimenz R, Reiter R J, Gitto E (2020). Use of melatonin in oxidative stress related neonatal diseases. Antioxidants. 9(6):477. doi:10.3390/antiox9060477.

Dugani S, Veillard J, Kissoon N (2017). Reducing the global burden of sepsis. Canadian Medical Association Journal. 189(1), E2–E3. doi: 10.1503/cmaj.160798.

El-Kabbany ZA, El-Farghali OG, Khafagy SM, Shaaban HA, Osman HHA Metwally MH (2020). Melatonin as an adjuvant therapy in preterm infants with neonatal sepsis, randomized trial. Egyptian Pediatric Association Gazette, 68(1).

El Frargy M, El-Sharkawy HM, Attia GF (2015). Use of melatonin as an adjuvant therapy in neonatal sepsis. Journal of Neonatal-Perinatal Medicine 8(3): 227–232.

El-Gendy FM, El-Hawy MA , Hassan MG (2018). The beneficial effect of melatonin in the treatment of neonatal sepsis. Journal of Maternal-Fetal and Neonatal Medicine, 31(17): 2299–2303.

Gitto E, Aversa S, Salpietro CD, Barberi I, Arrigo T, Trimarchi G, Reiter RJ, et al. (2012). Pain in neonatal intensive care: role of melatonin as an analgesic antioxidant. J Pineal Res. 52(3):291-5. doi: 10.1111/j.1600079X.2011.00941.x.

Gitto E, Aversa S, Reiter RJ, Barberi I, Pellegrino S (2011). Update on the use of melatonin in pediatrics. J Pineal Res. 50: 21-28.

Hidayah D, Salimo H, Wibowo T, Wasita B, Widyaningsih V, Hartono, Soetrisno. (2024). Melatonin, an adjuvant for neonatal sepsis: a systematic review and meta-analysis Study selection. 13(1): 101–105.

Hu Q, Hao C, Tang S (2020). From sepsis to acute respiratory distress syndrome (ARDS): emerging preventive strategies based on molecular and genetic research. Bioscience reports. 40(5), .doi:10.1042/BSR20200830

Kim W Y, Hong S B (2016). Sepsis and acute respiratory distress syndrome: recent update. Tuberculosis and respiratory diseases, 79(2): 53–57. doi:10.4046/trd.2016.79.2.53

Poggi C, Dani C (2018). Sepsis and oxidative stress in the newborn: from pathogenesis to novel therapeutic targets. Oxidative medicine and cellular longevity. doi:10.1155/2018/9390140.

Radogna F, Diederich M, Chibelli L (2010). Melatonin: a pleiotropic molecule regulating inflammation. Biochem Pharmacol. 80: 1844-1852. doi: 10.1016/j.bcp.2010.07.041.

Rieter RJ, Pardes SD, Manchester LC, Tan DX (2009). Reducing oxidative/ nitrosative stress: a newly discovered gene for melatonin. Crit Rev Biochem Mol Biol. 44: 175-200. doi: 10.1080/10409230903044914.

You T, Zhou YR, Liu XC, Li LQ (2022). Risk factors and clinical characteristics of neonatal acute respiratory distress syndrome caused by early onset sepsis. Front Pediatr. 28: 10:847827. doi: 10.3389/fped.2022.847827.

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Published

2024-09-16

How to Cite

Hidayah, D., & Nur Irfani Agita. (2024). The Efficacy of Melatonin in Neonatal Sepsis with Respiratory Distress: A Randomized Controlled Study. Journal of Maternal and Child Health, 9(5), 787–793. https://doi.org/10.26911/thejmch.2024.09.05.03

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Articles