Electrical cardiometry and fuctional echocardiographyin predicting and hemodynamic monitoring of neonatal sepsis

Objective: To determined the usefulness of functional trans-thoracic echocardiography (TTE) and electrical cardiometry(EC) parametersin predicting and detection of hemodymanic instability in cases of neonatal sepsis. Study design: observational cross-sectional study. Paired measurements were performed using TTE and ECto assess blood flow, contractility, vascular resistance and fluid status parameters. Results: Sixty-nine neonates (mean GA: 34.14±3.28 weeks) were enrolled.Mean stroke volume (SV) was 3.89±1.26 ml and 3.88±1.19 ml, mean cardiac output (CO) was 0.565±0.18 L/min and 0.56±0.17 L/minby EC and TTE; respectively.SV and CO difference between EC and TTE was within the accepted limit of agreement (Bias <10%; MPE<30%) except in preterm group were 18.2% and 34.5%; respectively.Low SV at 2.4 had 54% sensitivity and 54% specificity and CO at 0.36 had 62% sensitivity and 54% specificity while low HRV at 12.77 had 54% sensitivity and 79% specificity with area under the curve is 0.630 (95% confidence interval 0.419–0.841) for predicting sepsis. Conclusion: Monitoring of hemodynamic status using both EC and TTE help in early detection of hemodynamic instability in cases of neonatal sepsis.