Clinical profile and short-term outcomes in neonates with septic shock

ABSTRACT

Background: Neonatal sepsis is a syndrome causing severe organ dysfunction triggered by a dysregulated host in response to an infection, affecting millions of neonates. In such situations, early identification and management in the initial hours dramatically improves the outcome. Hence, it was taken up to study the incidence, clinical profile and short-term outcomes of neonates with septic shock.Methods: Hospital based prospective observational study on 95 neonates admitted to neonatal intensive care unit in the department of Paediatrics at Acharya Vinobha Bhave rural hospital, Sawangi, Wardha from 1st August 2016 to 31st July 2018.Neonates diagnosed with septic refractory shock were enrolled after taking IEC approval and assent form and those with non-septic aetiology shock were excluded. Statistical analysis was done to establish correlation between neonatal variables and outcome.Results: 95 neonates fulfilled the inclusion criteria and were recruited. Out of these, 37 and 53 were outborn and inborn respectively. Maximum neonates were preterm and males. Neonates with birth weight 1000-1499 grams to those less than 1000 was 4.21. Normal vaginal delivery was more common as compared to lower segment caesarean section (LSCS). Blood culture positivity was in 44.2%. Age of presentation with shock ranged from 1 to 20 days and duration of shock ranged from 2 hours to 192 hours. Most infants were ventilated (84%) and it was more among those who died.Conclusions: Septic shock is the most common type, carrying high morbidity and mortality (more than 60%). Laboratory and clinical parameters (TLC, Platelet count, CRP, Blood culture, duration of shock, HR, RR, BP or arterial blood gas) (p>0.05) did not carry a prognostic value in predicting the outcome of such neonates. Early identification and intervention remains the key in managing such a challenging neonatal condition.