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Observational Study
. 2022 Jun;25(2):233-239.
doi: 10.1007/s40477-021-00590-y. Epub 2021 May 15.

Pulmonary hypertension in late onset neonatal sepsis using functional echocardiography: a prospective study

Sujata Deshpande  1 , Pradeep Suryawanshi  2 , Shrikant Holkar  1 , Yogen Singh  3 , Rameshwor Yengkhom  1 , Jan Klimek  4 , Samir Gupta  5   6
Affiliations
Observational Study

Pulmonary hypertension in late onset neonatal sepsis using functional echocardiography: a prospective study

Sujata Deshpande et al. J Ultrasound. 2022 Jun.

Abstract

Purpose: Pulmonary hypertension (PH) in the newborn period is associated with significant morbidity and mortality. Sepsis has been identified as an independent risk factor for PH in newborns. Data on the proportion and severity of PH in association with neonatal sepsis are scarce. This study was aimed to measure the pulmonary artery systolic pressure (PASP) in neonates with late onset sepsis (LOS) and to estimate the proportion of PH in neonatal sepsis using functional echocardiography (FnECHO).

Methods: This prospective observational study was conducted at a tertiary neonatal intensive care unit (NICU). All neonates admitted in the NICU with suspected LOS underwent FnECHO within 6 hours of onset of clinical signs and PASP was recorded. Pulmonary hypertension was defined as PASP of > 35 mmHg. PASP of neonates with positive culture results (proven LOS) was compared with that of gestational age-matched stable controls without sepsis.

Results: Thirty three neonates with proven LOS were analysed (study group). Sixteen neonates (49%) in the study group had PH. Mean PASP of the study group was significantly higher than that of the control group (35.3 ± 10.13 mmHg and 12.58 ± 3.92 mmHg, respectively; P < 0.0001). None of the neonates in the control group had PH.

Conclusion: Pulmonary artery pressure was higher in neonates with late onset neonatal sepsis as compared to that of stable babies without sepsis. Pulmonary hypertension was seen in nearly half of term as well as preterm neonates with late onset sepsis.

Keywords: Functional echocardiography; Neonatal sepsis; Pulmonary hypertension.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Estimation of pulmonary artery systolic pressure (PASP) by echocardiography. a Tricuspid regurgitation (TR) jet in apical four-chamber view. b Measurement of peak velocity of the TR jet (V1) and gradient (PG1) between right ventricle and right atrium by continuous wave Doppler using modified Bernoulli’s equation
Fig. 2
Fig. 2
Flow diagram of the study subjects
Fig. 3
Fig. 3
Proportion of pulmonary hypertension among different gestational age groups of study subjects. PH pulmonary hypertension
See this image and copyright information in PMC

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