ISSN: 2640-2726
Authors: Mohammed Maged HEH, Khalifa SSM, Said Abdelfattah WAM, Hafez MZ*, Amin RH, Hassan MF and El-Sayad Abd El-Hamid M
Background: The osteopathological etiology of shock in newborn neonates is distinct and necessitates meticulous evaluation to guide targeted therapies. Timely diagnosis is essential for effective management. The prevalence of newborn septic shock in low-income nations is 26.8%, accompanied by a fatality rate of 35.4%. The research regarding the hemodynamic effects of noradrenaline in newborns is limited. Objective: This study aims to evaluate the effectiveness of noradrenaline on ventricular parameters and Vital parameters and blood gases in neonatal septic shock patients admitted to the neonatal critical care unit at Al-Azhar University hospitals. Methods: This prospective cohort study performed on 200 neonates with septic shock born in the delivery room of the Gynecology and Obstetrics Department admitted to the NICU at Al Azhar University Hospitals from September 2023 to June 2024. Parents and caregivers of neonates signed an informed consent form after explaining the advantages and possible risks of the study. The ethical committee of Al-Azhar University Hospitals approved the study protocol. Results: Neonatal characteristics distribution there were 71% patients had SGA (<10th centile), mean of birth weight ranged from 1230-3800 kg with mean of 2100.80±1740.11 kg, duration of shocked ranged from 4-12 days, with mean 7.96±6.13 days, NICU stay was ranged from 4-9 days with mean 6.82±3.10 days. Regarding the intraventricular hemorrhage among the studied neonates, most of patients had grade 1 by 20%, followed 9% had grades 3 and 7.5% had grades 2, then 2.5% only had grade 4. The mortality rate in neonates with septic shock under study was 26.5%. Regarding echocardiographic parameters, VO and FS were significantly higher at 1 hour of noradrenaline (288.30±163.9, 47.32±19.12) compared to an initiation (212.4±79.18, 29.50±14.01), (p˂0.05). MBP significantly improved after noradrenaline (37.82 ±8.22) compared to before noradrenaline (30.65 ±6.11). Conclusion: The death rate among infants with septic shock in this study was 26.5%. The administration of noradrenaline in addressing hemodynamic instability during neonatal septic shock plays a critical yet complex role in the neonatal intensive care environment. Noradrenaline significantly increases systemic vascular resistance and elevates mean arterial pressure, which is essential for preserving organ perfusion in at-risk newborns.
Keywords: Hemodynamic Instability; Neonates; Noradrenaline; Septic Shock; Mortality Rate
