Chinese Medical E-ournals Database

Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition) ›› 2025, Vol. 21 ›› Issue (01): 67 -72. doi: 10.3877/cma.j.issn.1673-5250.2025.01.009

Forum

Current research status of clinical application on treatment of neonatal septic shock based on bedside real-time ultrasound

Hao Chen1, Jianhua Fu1,()   

  1. 1. Department of Neonatology,Shengjing Hospital of China Medical University,Shenyang 110004,Liaoning Province,China
  • Received:2024-10-10 Revised:2025-01-09 Published:2025-02-01
  • Corresponding author: Jianhua Fu

Sepsis is one of the leading causes of neonatal mortality.Due to the underdeveloped organs and systems in neonates,sepsis can onset abruptly and progress rapidly,often leading to septic shock or even death of neonates.Therefore,early recognition and effective treatment are crucial for improving survival rates and outcomes of neonates with septic shock.Point-of-care ultrasound(POCUS)has been widely implemented in neonatal intensive care unit (NICU)due to its real-time,dynamic,and non-invasive advantages.Utilizing POCUS to assess various system functions,identify infectious foci,and to assess hemodynamic status can guide neonatologists in the early assessment and treatment of neonatal sepsis and septic shock.This article reviews the current research progress of advancements in the application of POCUS for early assessment of neonatal sepsis and septic shock,so as to enhance neonatologists'understanding and clinical application of POCUS technology in diagnosing and managing neonatal sepsis and septic shock,and to improve the rescue capabilities of neonatal septic shock.

[1]
Strunk T,Molloy EJ,Mishra A,et al.Neonatal bacterial sepsis[J].Lancet,2024,404(10449):277-293.DOI:10.1016/s0140-6736(24)00495-1.
[2]
Fleischmann-Struzek C,Goldfarb DM,Schlattmann P,et al.The global burden of paediatric and neonatal sepsis:a systematic review[J].Lancet Respir Med,2018,6(3):223-230.DOI:10.1016/S2213-2600(18)30063-8.
[3]
Spaggiari V,Passini E,Crestani S,et al.Neonatal septic shock,a focus on first line interventions[J].Acta Biomed,2022,93(3):e2022141.DOI:10.23750/abm.v93i3.12577.
[4]
Moore CL,Copel JA.Point-of-care ultrasonography[J].N Engl J Med,2011,364(8):749-757.DOI:10.1056/NEJMra0909487.
[5]
Mi L,Liu Y,Bei F,et al.Abnormal characteristics of inferior vena cava and abdominal aorta among neonates with early onset septic shock[J].Ital J Pediatr,2025,51(1):21.DOI:10.1186/s13052-024-01829-0.
[6]
Liu H,Xu C,Hu Q,et al.Sepsis-induced cardiomyopathy:understanding pathophysiology and clinical implications[J].Arch Toxicol,2025,99(2):467-480.DOI:10.1007/s00204-024-03916-x.
[7]
Landesberg G,Gilon D,Meroz Y,et al.Diastolic dysfunction and mortality in severe sepsis and septic shock[J].Eur Heart J,2012,33(7):895-903.DOI:10.1093/eurheartj/ehr351.
[8]
Sweeney DA,Wiley BM.Integrated multiorgan bedside ultrasound for the diagnosis and management of sepsis and septic shock[J].Semin Respir Crit Care Med,2021,42(5):641-649.DOI:10.1055/s-0041-1733896.
[9]
Havaldar AA.Evaluation of sepsis induced cardiac dysfunction as a predictor of mortality[J].Cardiovasc Ultrasound,2018,16(1):31.DOI:10.1186/s12947-018-0149-4.
[10]
Micek ST,Mcevoy C,Mckenzie M,et al.Fluid balance and cardiac function in septic shock as predictors of hospital mortality[J].Crit Care,2013,17(5):R246.DOI:10.1186/cc13072.
[11]
Miller LE,Stoller JZ,Fraga MV.Point-of-care ultrasound in the neonatal ICU[J].Curr Opin Pediatr,2020,32(2):216-227.DOI:10.1097/mop.0000000000000863.
[12]
Singh Y,Tissot C,Fraga MV,et al.International evidencebased guidelines on point of care ultrasound (POCUS)for critically ill neonates and children issued by the POCUS Working Group of the European Society of Paediatric and Neonatal Intensive Care(ESPNIC)[J].Crit Care,2020,24(1):65.DOI:10.1186/s13054-020-2787-9.
[13]
Rand KM,Austin NC,Inder TE,et al.Neonatal infection and later neurodevelopmental risk in the very preterm infant[J].J Pediatr,2016,170:97-104.DOI:10.1016/j.jpeds.2015.11.017.
[14]
Zhou Y,Bai L,Tang W,et al.Research progress in the pathogenesis of sepsis-associated encephalopathy [J].Heliyon,2024,10(12):e33458.DOI:10.1016/j.heliyon.2024.e33458.
[15]
Gong X,Weng B,Zhang X,et al.The molecular basis of brain injury in preterm infants with sepsis-associated encephalopathy[J].BMC Pediatr,2022,22(1):336.DOI:10.1186/s12887-022-03372-5.
[16]
El Shimy MS,El-Raggal NM,El-Farrash RA,et al.Cerebral blood flow and serum neuron-specific enolase in early-onset neonatal sepsis[J].Pediatr Res,2018,84(2):261-266.DOI:10.1038/s41390-018-0062-4.
[17]
Basu S,Dewangan S,Shukla RC,et al.Cerebral blood flow velocity in early-onset neonatal sepsis and its clinical significance[J].Eur J Pediatr,2012,171(6):901-909.DOI:10.1007/s00431-011-1643-y.
[18]
Car KP,Nakwa F,Solomon F,et al.The association between early-onset sepsis and neonatal encephalopathy[J].J Perinatol,2022,42(3):354-358.DOI:10.1038/s41372-021-01290-5.
[19]
Gunes AO,Bozkaya A.Endotracheal surfactant and budesonide combination therapy in neonatal acute respiratory distress syndrome due to late-onset sepsis[J].Arch Iran Med,2024,27(10):573-579.DOI:10.34172/aim.31725.
[20]
Vivalda L,Loi B,Bisceglie V,et al.Effect of preterm chorioamnionitis on lung ultrasound score used to guide surfactant replacement[J].Pediatr Pulmonol,2023,58(10):2761-2768.DOI:10.1002/ppul.26576.
[21]
Kurepa D,Zaghloul N,Watkins L,et al.Neonatal lung ultrasound exam guidelines[J].J Perinatol,2018,38(1):11-22.DOI:10.1038/jp.2017.140.
[22]
Mendes RS,Pelosi P,Schultz MJ,et al.Fluids in ARDS:more pros than cons[J].Intensive Care Med Exp,2020,8(Suppl 1):32.DOI:10.1186/s40635-020-00319-x.
[23]
Burgunder L,Heyrend C,Olson J,et al.Medication and fluid management of pediatric sepsis and septic shock[J].Paediatr Drugs,2022,24(3):193-205.DOI:10.1007/s40272-022-00497-z.
[24]
Mcnamara PJ,Jain A,El-Khuffash A,et al.Guidelines and recommendations for targeted neonatal echocardiography and cardiac point-of-care ultrasound in the neonatal intensive care unit:an update from the American Society of Echocardiography[J].J Am Soc Echocardiogr,2024,37(2):171-215.DOI:10.1016/j.echo.2023.11.016.
[25]
Rao YK,Arora S,Midha T,et al.Correlation of ultrasonographic measurement of inferior vena cava collapsibility index with central venous pressure in diagnosis and management of neonatal shock[J].Iran J Neonatol,2020,11(3):86-91.DOI:10.22038/ijn.2020.44748.1743.
[26]
Galdo F,Trappan A,Cossovel F,et al.Ultrasonographic measurements of the inferior vena cava diameter in newborns:is it a useful tool for choosing an umbilical venous catheter? [J].Front Pediatr,2023,11:1268622.DOI:10.3389/fped.2023.1268622.
[27]
Dempsey E,Rabe H.The use of cardiotonic drugs in neonates[J].Clin Perinatol,2019,46(2):273-290.DOI:10.1016/j.clp.2019.02.010.
[28]
Weiss SL,Peters MJ,Alhazzani W,et al.Surviving sepsis campaign international guidelines for the management of septic shock and sepsis-associated organ dysfunction in children[J].Intensive Care Med,2020,46(Suppl 1):10-67.DOI:10.1007/s00134-019-05878-6.
[29]
Lin SY,Chiang MC,Wu WH,et al.Point-of-care ultrasound (POCUS)for tip localization of neonatal peripherally inserted central catheter (PICC):A prospective study[J].Pediatr Neonatol,2024,65(4):375-380.DOI:10.1016/j.pedneo.2023.07.008.
[30]
Oulego-Erroz I,Alonso-Quintela P,Terroba-Seara S,et al.Ultrasound-guided cannulation of the brachiocephalic vein in neonates and preterm infants:a prospective observational study[J].Am J Perinatol,2018,35(5):503-508.DOI:10.1055/s-0037-1608803.
[1] Xu Wei, Ge Zhang, Jinlin Wu. Monitoring and treatment of neonatal sepsis-induced coagulopathy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2023, 19(04): 379-386.
[2] Qiao Lin, Hua Wang. Values of serum presepsin (sCD14-ST) in diagnosis of neonatal sepsis: a Meta-analysis[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2021, 17(06): 699-708.
[3] Meng He, Juan Chen, Jinlin Wu. Current status of immune response of mesenchymal stem cells by regulating the polarization of macrophages[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2019, 15(05): 492-496.
[4] Xiaoling Li, Wei Xiong, Hongxia Liu. Clinical Observation of Plasma Procalcitonin in Guiding Pediatric Systemic Inflammatory Response Syndrome Antibacterial Drug Therapy[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2014, 10(04): 483-486.
[5] De-hong SUN, Yong-feng YU, Gui-juan ZHAO, Ding-rong ZHANG, Shu-zhen XU. Immune Function Changes of Children With Hand-Foot-Mouth Disease Caused by Enterovirus 71 Infection and Its Clinical Significance[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2012, 08(04): 515-518.
[6] Yan Lin, Ronghua Yang, Shubin Ruan, Zepeng Lin, Xiangsheng Feng, Rui Shen, Fenggang Zhang, Xianglian Xiong, Xiaodong Chen. Clinical study of reducing the inflammatory response in deep partial thickness skin burns under the treatment of xenogeneic (porcine) acellular dermal matrix[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2017, 12(03): 187-190.
[7] Qingfu Zhang, Xuepo Gao. Roles of proinflammatory interleukin in the inflammatory response after burn injury[J]. Chinese Journal of Injury Repair and Wound Healing(Electronic Edition), 2015, 10(05): 427-430.
[8] Haibin Ji, Qiangpu Chen. Perioperative intestinal mucosal barrier damage and systemic inflammatory response syndrome in abdominal surgery[J]. Chinese Archives of General Surgery(Electronic Edition), 2018, 12(04): 280-283.
[9] Hua Wang, Wenyu Li. Correlation analysis of surgery for adhesive small intestinal obstruction and SIRS factor[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2019, 13(01): 61-64.
[10] Kai Lu, Zhihui Chen, Shaoqiang Ye, Feng Luo, Huilan Luo. Risk factors analysis of systemic inflammatory response syndrome after percutaneous nephrolithotomy[J]. Chinese Journal of Endourology(Electronic Edition), 2021, 15(04): 289-293.
[11] Xuwei He, Yang Liu, Qingli Cheng, Qiangguo Ao. Research progress on point-of-care testing of early biomarkers for acute kidney injury[J]. Chinese Journal of Kidney Disease Investigation(Electronic Edition), 2025, 14(01): 48-52.
[12] Ruoming Tan, Hongping Qu. Do we really not need high-volume hemofiltration?[J]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2017, 03(01): 65-68.
[13] Ling Fan. Pregnancy with septic shock[J]. Chinese Journal of Obstetric Emergency(Electronic Edition), 2017, 06(03): 138-141.
[14] Xin Ding, Shengzhen Wu, Zifeng Yang, Wenda Guan. Research progress of Point-of-care testing of influenza virus[J]. Chinese Journal of Clinical Laboratory Management(Electronic Edition), 2022, 10(01): 41-49.
[15] Guoren Li. Prevention and treatment of systemic inflammatory reaction and its syndrome after thoracic surgery[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2017, 04(01): 49-55.
Viewed
Full text


Abstract