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Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
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Functional echocardiographic preload markers in neonatal septic shock
Shiv Sajan Saini1, Venkataseshan Sundaram1, Praveen Kumar1
1Division of Neonatology, Department of Paediatrics, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Summary
Neonates with septic shock show higher baseline inferior vena cava collapsibility index (IVC-CI) than healthy infants. Echocardiographic preload markers did not significantly change after fluid resuscitation in neonatal septic shock.
Area of Science:
- Neonatal Medicine
- Pediatric Cardiology
- Critical Care Medicine
Background:
- No established markers for preload adequacy in neonatal shock.
- Echocardiographic markers studied in adults and children, but not neonatal septic shock.
- This study evaluates functional echocardiographic preload markers in neonatal septic shock.
Purpose of the Study:
- Compare baseline echocardiographic preload markers in neonates with septic shock versus healthy controls.
- Assess changes in echocardiographic preload markers before and after fluid resuscitation in neonatal septic shock.
Main Methods:
- Cohort study analyzing 46 neonates (23 septic shock, 23 controls).
- Measured five echocardiographic preload markers: IVC collapsibility index (IVC-CI), LVEDV, LVESV, LVEDVI, LVESVI.
- Markers assessed at baseline and post-resuscitation in septic neonates; single assessment in controls.
Main Results:
- Neonates with septic shock had significantly higher baseline IVC-CI than controls (53% vs. 20%, p=0.01).
- Other echocardiographic markers were comparable between groups.
- No significant changes in preload markers post-fluid resuscitation, including IVC-CI (p=0.05).
Conclusions:
- Elevated baseline IVC-CI in neonatal septic shock compared to stable neonates.
- Echocardiographic preload markers, including IVC-CI, did not significantly change after fluid resuscitation.
- Further research needed to establish reliable preload assessment in neonatal septic shock.
