Cerebral Hemodynamics in Late Onset Neonatal Sepsis in Preterm Neonates: A Prospective Observation Study

Authors

  • Chinmay Chetan Assistant Professor, Department of Neonatology, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India
  • Bhvya Gupta Consultant Neonatology, Sparsh Superspeciality Hospital, Ambala, Haryana, India.
  • Prince Pareek Consultant Neonatology, ESIC Medical College and Hospital, Faridabad, Haryana, India
  • Sonali Suryawanshi Associate Professor, Department of Pharmacology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India
  • Rajesh Maheshwari Consultant, Department of Neonatology, Westmead Hospital, Westmead, NSW, Australia.
  • Pradeep Suryawanshi Professor, Department of Neonatology, Bharati Vidyapeeth University Medical College, Pune, Maharashtra, India.

DOI:

https://doi.org/10.60086/jnps530

Keywords:

Anterior cerebral artery; cerebral blood flow; Neonatal sepsis; Resistive index

Abstract

Introduction: Late onset neonatal sepsis (LONS) is one of the most prevalent conditions in neonates in developing countries. The aim of this study was to assess the changes in cerebral hemodynamics in neonates with LONS.

Methods: Preterm neonates (N = 60) with suspected LONS were enrolled over a period of 21 months and divided into three cohorts: Group A with clinical sepsis but with negative septic markers and culture report, group B, where septic markers were positive, but cultures were sterile and group C, where either blood or CSF culture was positive. Ultrasound doppler of the anterior cerebral artery was done at 0 hrs, 48 hrs and 5th day after suspecting sepsis. Peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistive index (RI) were measured and compared in three groups and sequentially at specific time points.

Results: A total of 60 neonates with a median gestational age of 30.5 [IQR (28 - 32.6)] weeks were enrolled: 21 in group A, 20 in group B and 19 in group C. RI was lowest in Group C at zero hours with a mean of 0.72 (SD ± 0.09) [p < 0.05], which gradually improved after starting antibiotics. Klebsiella sp. was the most common organism isolated.

Conclusion: Neonates with culture-positive LONS had the least resistive index. This parameter may have diagnostic implications and significance on the hemodynamic management in LONS.

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Published

2024-03-17

Issue

Vol. 43 No. 3 (2023)

Section

Original Articles