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

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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.

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Authors and Affiliations

  1. Department of Neonatology, Bharati Vidyapeeth University Medical College and Hospital, Dhankawadi, Pune, 411043, India

    Sujata Deshpande, Pradeep Suryawanshi, Shrikant Holkar & Rameshwor Yengkhom

  2. Cambridge University Hospitals, Cambridge, United Kingdom

    Yogen Singh

  3. Westmead Hospital, Westmead, Australia

    Jan Klimek

  4. Division of Neonatology, Sidra Medicine, Doha, Qatar

    Samir Gupta

  5. Durham University, Durham, United Kingdom

    Samir Gupta

Authors
  1. Sujata Deshpande
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  2. Pradeep Suryawanshi
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  3. Shrikant Holkar
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  4. Yogen Singh
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  5. Rameshwor Yengkhom
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  6. Jan Klimek
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  7. Samir Gupta
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Contributions

SD and PS contributed to concept and design, analysis and interpretation of data, and drafting and revising of article; SH and RY to acquisition and analysis of data and drafting of article; YS, JK, and SG to analysis and interpretation of data and revising article for intellectual content. All authors contributed to final approval of version to be published.

Corresponding author

Correspondence to Pradeep Suryawanshi.

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The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the study were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from parents/caregivers of infants eligible for the study.

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Deshpande, S., Suryawanshi, P., Holkar, S. et al. Pulmonary hypertension in late onset neonatal sepsis using functional echocardiography: a prospective study. J Ultrasound 25, 233–239 (2022). https://doi.org/10.1007/s40477-021-00590-y

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  • DOI: https://doi.org/10.1007/s40477-021-00590-y

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