Non invasive monitoring of haemodynamics and its changes during systemic infection in neonatal patients

During the neonatal period, the physiology of the cardiovascular system is still evolving, and cardiac function, especially in the preterm infant, differs significantly from that in the older people. Not surprisingly, the monitoring, assessment, and treatment of haemodynamic disorders remain one of the greatest challenges in neonatology. The most accurate are invasive methods to monitor haemodynamics in adults. However, they are not suitable for newborns, as they can cause various complications and be dangerous to the patient’s health. Non-invasive technologies allow to assess the characteristics of haemodynamics and identify its disorders objectively and without any harm to the patient. Echocardiography is the most widely used instrumental examination to assess cardiac function in severely ill patients. An alternative to traditional echocardiography could be a non-invasive ultrasound cardiac output monitor USCOM. Therefore, our first aim of the study was to compare neonatal hemodynamic parameters obtained using those two methods, i. e. to find out whether USCOM could partially replace functional echocardiography at the patient’s bedside when there is no possibility to repeat the ultrasound examination as needed. Another thing is that neonatal reference values provided by a USCOM manufacturer are calculated based on certain formulas and algorithms rather than presented in a population-specific study. This prompted us to investigate the main hemodynamic parameters of haemodynamically stable neonates of various gestational ages and to determine their reference values specific to this particular method. Having the reference values, we were later able to compare them with the most important indicators of hemodynamics in neonates with systemic infection and to determine the changes during that illness