Comparison of Functional Echocardiographic Markers in Septic and Non-Septic Neonate

Abstract

Background: Neonatal sepsis accounts for significant morbidity and mortality and its hemodynamics is complex. Functional echocardiography is emerging at a rapid pace and currently it is considered as a key tool for providing real time information on cardiovascular performance. Objective: To assess and compare functional Echocardiographic markers in septic and non-septic neonate. Methodology: This cross-sectional comparative study was conducted in the Department of Neonatology, BSMMU over an Eighteen-month period from March 2022 to August 2023. 25 neonates including term baby and preterm ≥ 34 weeks with early or late-onset sepsis satisfying the inclusion criteria were enrolled for the study and compared with same gestational age matched healthy control. Result: Comparison of functional echocardiographic parameters between two groups were statistically significant in respect to right and left ventricular output and tricuspid annular plane systolic excursion. Cardiac output was increased (rt. ventricular output 277.4 ± 74.2 Vs 209 ± 70, lt. ventricular output 339.5 ± 43.2 Vs 276 ± 74.9, p-values were 0.002 and 0.001 respectively) and tricuspid annular plane systolic excursion (0.49 ± 0.13 Vs 0.74 ± 0.34, p value 0.001) was decreased in septic neonate compared to healthy counterpart. The result was also statistically significant result in respect to right and left ventricular output and tricuspid annular plane systolic excursion (p-values were 0.039, 0.004 and 0.01) respectively in comparison between preterm septic and non-septic newborn. When compared between the term neonates (37 weeks to 40 weeks) of both groups, there were also statistically significant result in respect to right ventricular output, left ventricular output and tricuspid annular plane systolic excursion (p- values were 0.006,0.03 and 0.025) respectively. Conclusion: Significant cardiovascular changes like cardiac output and right ventricular systolic dysfunction evidenced by Functional Echocardiography, were common association of neonatal sepsis in comparison to non-septic neonate.