Neonatal sepsis and cardiovascular dysfunction I: mechanisms and pathophysiology

Sophie M. Duignan, Satyan Lakshminrusimha, Kathryn Armstrong, Willem P. de Boode, Afif El-Khuffash, Orla Franklin, Eleanor J. Molloy*, Willem P. de Boode, Franz B. Plötz, Tobias Strunk, Marina Degtyareva, Helmut Küster, Eric Giannoni, Joseph M. Bliss, H. Rob Taal, Claus Klingenberg, Lars Naver, Agnes van den Hoogen

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Abstract: The highest incidence of sepsis across all age groups occurs in neonates leading to substantial mortality and morbidity. Cardiovascular dysfunction frequently complicates neonatal sepsis including biventricular systolic and/or diastolic dysfunction, vasoregulatory failure, and pulmonary arterial hypertension. The haemodynamic response in neonatal sepsis can be hyperdynamic or hypodynamic and the underlying pathophysiological mechanisms are heterogeneous. The diagnosis and definition of both neonatal sepsis and cardiovascular dysfunction complicating neonatal sepsis are challenging and not consensus-based. Future developments in neonatal sepsis management will be facilitated by common definitions and datasets especially in neonatal cardiovascular optimisation. Impact: Cardiovascular dysfunction is common in neonatal sepsis but there is no consensus-based definition, making calculating the incidence and designing clinical trials challenging.Neonatal cardiovascular dysfunction is related to the inflammatory response, which can directly target myocyte function and systemic haemodynamics.

Original languageEnglish
Pages (from-to)1207–1216
JournalPediatric Research
Volume95
DOIs
Publication statusPublished - 2024

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