CLINICOETIOLOGICAL PROFILE, MANAGEMENT AND OUTCOME OF NEONATAL SHOCK PRESENTING WITHIN FIRST 72 HOURS OF LIFE

Objective: To study the ethology, presentation, response to treatment and outcome of neonatal shock which is one of the most common causes of morbidity and mortality in neonates while at the same time being amongst the less studied topics in pediatrics, with data from children and adult being extrapolated to the neonates. Study Design: This was a cross sectional observational study done in a government hospital of north India from 1 January 2023 to 30 April 2023.All the neonates aged 0 – 72 hours who presented to the neonatal intensive care unit (NICU) of the pediatric department of the hospital as a case of shock were included in the study. Shock was defined as decreased perfusion, altered mental status, diminished or bounding pulses, cool extremities or decreased urine output. Results: Our study included 71 patients (54.9% males and 45.1% females) out of which 77.5 % participants presented within 24 hours of birth. 54.9% babies had normal weight and 47.9% were early term. Babies born via LSCS were more likely to develop and present earlier with shock. 43.7% cases were attributed to respiratory distress syndrome, 32.4% cases to perinatal asphyxia and 27.1% to sepsis. Sepsis and Meconium aspiration were more likely to present earlier. 25.4% required triple inotropic support and 7% had catecholamine refractory shock. Mortality was 18.3% with maximum mortality seen in patients on triple inotropic support, all of whom presented with shock at less than 24 hours of age.