Efficacy of Cranial Doppler ultrasound in Diagnosis of Early-onset neonatal sepsis

Abstract

Background: Neonatal sepsis is considered a major neonatal issue and associated with a high rate of mortality in newborns. Because there is a lack of studies concerning early hemodynamic changes of cerebral circulation in neonatal sepsis, so our research aims to assess the cerebral blood flow (CBF) changes in newborns with early-onset neonatal sepsis (EONS) and to clarify the role of cranial Doppler Ultrasound in EONS diagnosis. Objective: To evaluate cerebral hemodynamic changes using transcranial Doppler in newborns with EONS. Methods: This cross-sectional study with 50 neonates involved in the study. The neonates were classified into 2 groups: Case Group (25 neonates) with a diagnosis of early-onset neonatal sepsis and control group (25 neonates) without clinical manifestations of sepsis. Examination of all neonates using Transcranial Doppler (TCD) was performed within seventy-two hours after birth. Measurement of cerebral blood flow velocity (CBFV) in two major cerebral vessels: The anterior cerebral artery (ACA) and middle cerebral artery (MCA) with documentation of doppler data: The peak systolic velocity (PSV), pulsatility index (PI), and resistive index (RI). Data were statistically analyzed followed by calculation of specificity, sensitivity, positive and negative predictive value at selected cut-off values of CBFV parameters. Results: Sepsis group showed statistically significant changes in doppler indices with increased PSV and deceased PI and RI in both arteries. Conclusion: the present study demonstrates changes in CBFV measured by transcranial Doppler in newborns with EONS which can be used as noninvasive bedside investigation.