الفهرس 
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Abstract
SUMMARY
Neonatal sepsis it is still the leading cause of newborn mortality and morbidity despite recent improvements in health care facilities. A neonatal mortality rate of more than 40% results in the deaths of more than 3.1 million newborns every year. Sepsis is defined as a clinical syndrome in an infant 28 days of life or younger, manifested by systemic signs of infection and isolation of a bacterial pathogen from the blood stream. Neonatal sepsis classified into early/late-onset sepsis, depending on whether symptoms appear before/after 72 hours of age.
The main cause of death in sepsis is organ system failure initiated by cellular hypoxia. This condition is caused by the formation of microthrombi in small blood vessels which impair the blood flow. Some studies have suggested that blood lactate levels may be used to assess tissue perfusion and be a marker for the onset of tissue hypoxia. The liver is commonly involved in the multiple organ dysfunction syndrome caused by sepsis.Liver dysfunction can lead to coagulation dysfunction and ammonia metabolism disorder, lead to abnormal blood coagulation and elevated serum ammonia level. In recent years, studies proved that sepsis may cause swelling of intestinal mucosa, leading to defective barrier function and intestinal bacterial translocation, which aggravate systemic infection and cause additional ammonia in the intestine to be absorbed into the blood
Prognostic markers in sepsis are useful for identifying patients at increased risk of death, selecting which therapies are most appropriate in certain situations and guiding the response to treatment over time.
This study was designed to evaluate the prognostic value of serum lactate and ammonia in neonatal sepsis
We conducted a prospective case control observational study at neonatal intensive care unit at Beni-suef university Hospital from December 2020 till December 2021. The study included 100 patients with neonatal sepsis and another 20 healthy as a control group.All participants were subjected to History taking , Clinical examination, follow up for occurrence complications and the outcome whether improve or died and Laboratory investigations including CBC, CRP, blood culture, serum lactate ,ammonia and ferritin.
We found significantly higher levels of serum lactate and serum ammonia in neonates with compared to control group, there was a significant role of lactate in prediction of mortality and occurrence of complications in neonatal sepsis but there was no a significant role of serum ammonia prediction of mortality in neonatal sepsis .
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