Background: There are no established clinical or laboratory markers of preload adequacy and fluid responsiveness in management of neonatal shock. Functional echocardiographic preload markers are evaluated in children and adults, but there is no data in neonatal septic shock. We evaluated five functional echocardiographic preload markers during intravenous volume resuscitation in neonatal septic shock.
Objective: (1) To compare baseline functional echocardiographic preload markers between neonates with septic shock and their "matched" healthy controls. (2) To compare echocardiographic preload markers before and after intravenous volume resuscitation.
Methods: In this cohort study, we enrolled neonates with septic shock (cases) and recorded five preload markers - inferior vena cava collapsibility index (IVC-CI), left ventricular end-diastolic (LVEDV) & end-systolic volume (LVESV) and their indices (LVEDVI, LVESVI) - before initiation of intravenous fluid resuscitation (baseline evaluation). An equal number of "matched hemodynamically stable" controls were recruited, who underwent functional echocardiographic assessment once. In neonates with shock, we recorded these markers again after volume resuscitation.
Results: We analyzed 46 neonates (23 cases and 23 controls). Neonates with shock had significantly elevated baseline IVC-CI as compared to controls [53% (21, 100) vs. 20% (15, 24) respectively, -value = .01). Rest 4 echocardiographic markers (LVEDV, LVESV, LVEDVI, and LVESVI) were comparable between cases and controls. Sixteen neonates (70% of 23) received intravenous fluid resuscitation and rest 7 (30%) were started directly on vasoactive drugs. None of the preload markers changed significantly after volume resuscitation as compared to the baseline values including IVC-CI, which was almost significant [74% (33, 100) at baseline to 48% (13, 93) after 10 mL/kg and 50% (40, 69) after 20 mL/kg, ( = .05). All preload markers were comparable between survivors and non-survivors.
Conclusion: Neonates with septic shock had significantly elevated IVC-CI at baseline as compared to hemodynamically stable neonates. None of the preload markers changed significantly after volume resuscitation as compared to the baseline values including IVC-CI, which was almost significant.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1080/14767058.2021.1926447 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Energy loss and adults with congenital heart disease: a novel marker of cardiac workload beyond right ventricular size.
Cardiovasc Diagn Ther
December 2024
Cardiovascular Center, St. Luke's International Hospital, Tokyo, Japan.
Right ventricular (RV) dysfunction after biventricular repair is critical in most adults with congenital heart disease (ACHD). Conventional 2D magnetic resonance imaging (MRI) measurement is considered as a 'gold standard' for RV evaluation; however, addition information on ACHD after biventricular repair is sometimes required. The reasons why adjunctive information is required is as follows: (I) to evaluate the severity of cardiac burden in symptomatic patients with normal RV size and ejection fraction (EF), (II) to determine the optimal timing of invasive treatments in asymptomatic ones, and (III) to detect proactively a potential cardiac burden leading to ventricular deterioration, from a fluid dynamics perspective.
View Article and Find Full Text PDFOrthostatic intolerance with tachycardia (postural tachycardia syndrome) and without (hypocapnic cerebral hypoperfusion) represent a spectrum of the same disorder.
Front Neurol
October 2024
Department of Neurology, Brigham and Women's Hospital, Boston, MA, United States.
Background: Spectrum of chronic orthostatic intolerance without orthostatic hypotension includes postural tachycardia syndrome (POTS), with orthostatic tachycardia and hypocapnic cerebral hypoperfusion (HYCH), without orthostatic tachycardia. This study compared autonomic, cerebrovascular, and neuropathic features of POTS and HYCH.
Methods: This retrospective study evaluated patients with orthostatic intolerance referred for autonomic testing.
A Real-Time Approach for Assessing Rodent Engagement in a Nose-Poking Go/No-Go Behavioral Task Using ArUco Markers.
Bio Protoc
November 2024
Department of Bioengineering, The University of Texas at Dallas, Richardson, TX, USA.
Behavioral neuroscience requires precise and unbiased methods for animal behavior assessment to elucidate complex brain-behavior interactions. Traditional manual scoring methods are often labor-intensive and can be prone to error, necessitating advances in automated techniques. Recent innovations in computer vision have led to both marker- and markerless-based tracking systems.
View Article and Find Full Text PDFSuccess rate of fiducial marker placement for treatment of esophageal or rectal cancers: a prospective multicenter study (FIDECHO study) (with video).
Gastrointest Endosc
August 2024
Centre d'endoscopie digestive, Hôpital Saint Antoine, APHP, Paris, France. Electronic address:
Article Synopsis
- A multicenter study assessed the feasibility and safety of EUS-guided fiducial marker placement in patients with esophageal or rectal cancer referred for radiation therapy, focusing on success rates and outcomes.
- The study involved 33 patients, achieving a 93.9% success rate in marker placement, with an average procedure time of 12.5 minutes and no reported adverse events.
- Results showed that all fiducial markers remained visible throughout radiation therapy, emphasizing the approach's safety and effectiveness for these cancer types.
Interventions to improve glycaemic control in people living with, and at risk of developing type 2 diabetes.
Diabetes Obes Metab
September 2024
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Type 2 diabetes mellitus is one of the most prevalent health conditions worldwide, affecting millions of individuals and posing significant public health challenges. Understanding the nature of type 2 diabetes, its causes, symptoms and treatments is crucial for managing and preventing its complications. Many different dietary strategies are used by individuals to treat and manage diabetes.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!