Predictors of Outcomes of Neonatal Shock
Onkar Prasad Khandwal, Virendra Kurrey, Pushpraj Pradhan
Abstract
Background: Shock is an independent risk factor of neurologic impairment and mortality in neonates. Failure of perfusion may affect isolated organs or the entire body.
Aim: To study the markers of shock in neonates and outcomes of shock and their correlation with various parameters
Materials and Methods: This was a single-center, prospective, observational study. A sample of 261 neonates diagnosed with shock and admitted to the NICU were enrolled. Details of each neonate’s medical history, clinical findings, results of the investigations, and interventions (such as inotrope therapy, antibiotic therapy, and mechanical ventilation) were recorded in a predesigned proforma. The data were subject to statistical analyses.
Results: About two-third of the 261 (67.82%) neonates enrolled were female. More than 50% of the neonates (57.47%) had a low birth weight, about one-fourth of the neonates were born at a low gestational age, and 30% of them had perinatal asphyxia (PA). Arterial blood gas analysis showed that most neonates (84.59%) had acidosis. Electrolyte analysis showed that 81.61% neonates had hyponatremia, and 81.99% neonates had hypocalcemia. Inotrope was discontinued in about 48.66% neonates, and 75% neonates improved after the treatment. Respiratory distress, preterm birth, and PA were found to influence the outcomes of interventions administered to treat shock (P < .05).
Conclusion: Very low birth weight, low birth weight, low gestational age, PA, apnea, severe hypocalcemia, and mild acidosis are independent predictors of outcomes in neonates with shock.
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