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Updated: Aug 20, 2025
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
[Value of functional echocardiographic parameters in predicting refractory septic shock in neonates]
Jun-Juan Zhong1, Jing Mo1, Chun Shuai1
1Department of Neonatology, Guangdong Women and Children's Hospital/Guangdong Neonatal ICU Medical Quality Control Center, Guangzhou 510000, China.
Objectives:
To study the value of functional echocardiographic parameters in predicting refractory septic shock in neonates.
Methods:
A total of 72 neonates with septic shock were enrolled. According to the highest value of septic shock score, they were divided into two groups: refractory (n=30) and non-refractory (n=42). The two groups were compared in terms of clinical data, laboratory findings, and functional echocardiographic parameters. The receiver operating characteristic (ROC) curve was used to evaluate the performance of functional echocardiographic parameters in predicting refractory septic shock.
Results:
Compared with the non-refractory group, the refractory group had significantly lower cardiac output and cardiac index (CI) and a significantly higher mean arterial pressure (MAP)/CI ratio (P<0.05). CI had a cut-off value of 2.6 L/(min·m2), a sensitivity of 79%, a specificity of 83%, and an area under the ROC curve (AUC) of 0.841 in predicting septic shock-related death (P<0.05), and MAP/CI ratio had a cut-off value of 11.4, a sensitivity of 83%, a specificity of 73%, and an AUC of 0.769 (P<0.05). CI had a cut-off value of 2.9 L/(min·m2), a sensitivity of 69%, a specificity of 69%, and an AUC of 0.717 in predicting all-cause death within 28 days (P<0.05).
Conclusions:
CI and MAP/CI ratio can be useful for early prediction of septic shock-related death in neonates.
