Electrical Cardiometry versus Echocardiography in Assessment of Hemodynamic Status in Preterm Neonates with Septic Shock
Noura Abdou *
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Heba Elmahdy
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Osama Tolba
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Nihal Shihab
Public Health Department, Tanta University Hospital, Tanta, Egypt.
Asmaa Elmesiry
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
Mohammed Rowisha
Pediatric Department, Tanta University Hospital, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Severe sepsis combined with hypotension or the requirement for vasopressors in newborns is known as neonatal septic shock and occurs even when the body is receiving enough fluids to revive it.
Hemodynamic monitoring in this condition can be through clinical assessment or using invasive and non-invasive tools like functional Echocardiography. Electrical Cardiometry (EC) has emerged as a continuous and non-invasive measurement of (CO) cardiac output. It has FDA approval and has been verified for usage in newborns.
Methods: All preterm infants admitted to the NICU who have been diagnosed with septic shock and have a gestational age between (34 0/7 and 36 6/7 weeks). 80 healthy neonates who were allocated for gestational age and sex made up the control group. Electrical cardiometry assessment was carried out throughout the first, second, third days of sepsis symptoms and prior discharge.
Results: In warm septic shock group; cardiac output (CO), stroke volume (SV), and cardiac index measured by electrical cardiometry (EC) had been substantially greater at the second evaluation contrasted to last evaluations in comparison to control group. There was no significant difference as regard contractility index (ICON) between both readings in both groups. Systemic vascular resistance (SVR) was significantly lower at 2nd evaluation in comparison to last evaluations than in control group. In cold septic shock group, SV, CO and cardiac index measured by EC were substantially lower at 2nd evaluation contrasted to last evaluations in comparison to control group. ICON was significantly lower at 2nd readings in comparison to last readings in both groups. SVR was significantly higher at 2nd evaluation in cold septic shock in contrast to control group.
Conclusion: Electrical cardiometry is a valuable tool of bedside hemodynamic monitoring and management in cases with neonatal septic shock.
Keywords: Septic shock, electrical cardiometry, inotropes