The value of early hemodynamic parameters in neonates with septic shock

Abstract

This study aims at determining the value, if any, of hemodynamic parameters in early septic shock incidence among the neonatal population. Eighty-two neonates with septic shock were divided into “survivors” and “non-survivors” according to their survival status within 4 weeks (28-days). The differences in stroke volume (SV), cardiac output (CO), cardiac index (CI) and systemic vascular resistance index (SVRI) were compared between survivors and non-survivors. Receiver operating characteristic (ROC) curves for 28-day mortality were constructed to compare the area under the curve (AUC) among SV, CO and CI. The test characteristics of the different cut-off values, including sensitivity, specificity, area under the ROC curve (AUC), positive likelihood and negative likelihood ratio were equally examined. Of 82 cases of neonates with septic shock in this study, 52 were survivors and 30 non-survivors. The hemodynamic parameters of SV, CO and CI were higher in survivors than in non-survivors (all p < 0.05). The AUC values of SV, CO and CI to predict 28-day mortality were 0.724, 0.742, and 0.729, respectively. Stroke volume had sensitivity, specificity, PPV, and NPV of 75.0, 75.0, 40.9 and 92.9%, respectively. Cardiac output had sensitivity, specificity, PPV, and NPV of 91.7, 55.7, 67.6 and 96.7%, respectively. CI had sensitivity, specificity, PPV, and NPV of 91.7, 67.3, 60.7 and 97.2%, respectively. CO achieved the highest AUC, sensitivity and PPV. In conclusion, SV, CO and CI may be valuable in the early stage of septic shock among the neonates.