The guiding value of inferior vena cava diameter, inferior vena cava collapse index and inferior vena cava to abdominal aorta ratio in neonates with early onset septic shock

Abstract

Background Shock is a potentially fatal condition in neonates that requires timely fluid resuscitation and hemodynamic monitoring. Echocardiography may improve assessment and treatment, but reference values across gestational age (GA) and birth weight (BW) are lacking. This study aimed to correlate key indicators with GA and BW of newborns with nonhemodynamic abnormalities, provide corresponding reference ranges, and evaluate them in neonates with early onset septic (EOS) -shock. Methods A total of 200 control group newborns were enrolled, and the inferior vena cava diameter (IVC), inferior vena cava collapse index (IVC-CI), and inferior vena cava to abdominal aorta ratio (IVC/AO) were recorded using echocardiography. Neonates were grouped based on GA, BW, days of age, and patent ductus arteriosus (PDA). 18 cases of neonatal EOS shock were also monitored using echocardiography. Results IVC and AO significantly increased with GA and BW (P < 0.05). IVC-CI and IVC/AO did not correlate with GA, BW, day of age, and PDA. Compared to control group, the EOS-shock group had significantly decreased IVC and IVC/AO and increased IVC-CI (P < 0.05). Cut-off values for indicating EOS-shock were > 34.15% for IVC-CI, < 47.58% for IVCmin/AO, and < 66.11% for IVCmax/AO. Conclusions IVC-CI, IVCmin/AO, and IVCmax/AO are applicable to all neonates. Although the number of neonates with EOS-shock is limited, the cut-off values still show certain diagnostic value. Further research is needed to determine the universality of the population and the role in the diagnosis and treatment of shock in neonates.