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The following is a summary of “Cardiopulmonary Physiology of Hypoxemic Respiratory Failure among Preterm Infants with Septic Shock,” published in the November 2024 issue of Pediatrics by Kharrat et al.
Preterm neonates with septic shock often experience hypoxemic respiratory failure (HRF), which may affect cardiopulmonary function.
Researchers conducted a retrospective study to examine cardiopulmonary physiological changes in preterm infants with septic shock and HRF.
They included neonates <34 weeks gestational age (GA) with septic shock who underwent comprehensive neonatal echocardiography (TNE) (≤72 hours of sepsis onset) and compared those with and without HRF.
The results showed 52 infants with septic shock, 19 (37%) had HRF. The HRF group more frequently had bidirectional/right-to-left flow across the patent ductus arteriosus (PDA) (67% vs. 33%; P=0.08). Pulmonary vascular resistance (PVR) and right ventricular (RV) function were similar across both groups. The HRF group showed reduced left ventricular (LV) systolic function (ejection fraction: 51.8±12.3% vs. 62.6±13.0%; global peak systolic longitudinal strain -15.2±4.5% vs. -18.6±4.5%) and diastolic function (early: 2.3±1.0 vs. 3.6±1.2/s, late: 2.4 (1.9, 2.6) vs. 2.8 (2.3, 3.5) diastolic strain rate). Additionally, 44% of the HRF group had LV output <150 ml/min/kg compared to 12% in the non-HRF group (all P<0.05).
They concluded that acute HRF in preterm neonates with septic shock was linked to impaired LV function but not to changes in PVR or RV function.
Source: jpeds.com/article/S0022-3476(24)00487-6/abstract
