Abnormal Heart Rate Characteristics Preceding Neonatal Sepsis and Sepsis-Like Illness

@article{Griffin2003AbnormalHR,
  title={Abnormal Heart Rate Characteristics Preceding Neonatal Sepsis and Sepsis-Like Illness},
  author={M. Pamela Griffin and Thomas Michael O'Shea and Eric A. Bissonette and Frank E. Harrell and Douglas E. Lake and J. Randall Moorman},
  journal={Pediatric Research},
  year={2003},
  volume={53},
  pages={920-926}
}
Late-onset neonatal sepsis is a significant cause of morbidity and mortality, and early detection could prove beneficial. Previously, we found that abnormal heart rate characteristics (HRC) of reduced variability and transient decelerations occurred early in the course of neonatal sepsis and sepsis-like illness in infants in a single neonatal intensive care unit (NICU). We hypothesized that this finding can be generalized to other NICUs. We prospectively collected clinical data and continuously… 

Figures and Tables from this paper

Heart rate characteristics: physiomarkers for detection of late-onset neonatal sepsis.
Heart Rate Characteristics and Laboratory Tests in Neonatal Sepsis
TLDR
It is found that the clinical diagnosis of neonatal sepsis is preceded by abnormal heart rate characteristics (HRC) of reduced variability and transient decelerations, and a predictive HRC monitoring strategy based on multivariable logistic regression analysis that was developed at one tertiary care NICU and validated at another.
Heart Rate Characteristics in Neonatal Sepsis: A Promising Test That Is Still Premature
TLDR
A specific group of measures (or metrics) of heart rate variability, termed the heart rate characteristics (HRC) index, and its association with blood-culture–proven sepsis in neonates are reported on.
Heart Rate Characteristics and Clinical Signs in Neonatal Sepsis
TLDR
It is concluded that clinical signs of illness and HRC monitoring add independent information to one another in the diagnosis of neonatal sepsis.
Sepsis and Mortality Prediction in Very Low Birth Weight Infants: Analysis of HeRO and nSOFA.
TLDR
The HRC index provides earlier warning of imminent sepsis, whereas nSOFA after blood culture provides better prediction of mortality, adding to existing literature evaluating these risk scores independently and in cases of not only proven but also suspected infections.
Peripheral Perfusion Index as a Marker of Sepsis in Preterm Neonates
TLDR
This study shows that PI might serve as an early, non-invasive marker of hospital acquired sepsis in preterm neonates.
Body temperature patterns as a predictor of hospital-acquired sepsis in afebrile adult intensive care unit patients: a case-control study
TLDR
Abnormal body temperature curves were predictive of the diagnosis of sepsis in afebrile critically ill patients and analysis of temperature patterns, rather than absolute values, may facilitate decreased time to antimicrobial therapy.
Predictive monitoring for sepsis and necrotizing enterocolitis to prevent shock.
Cardiovascular oscillations at the bedside: early diagnosis of neonatal sepsis using heart rate characteristics monitoring.
TLDR
It is found that measurements of standard deviation, sample asymmetry and sample entropy are highly related to imminent clinical illness.
Heart Rate Characteristics Monitoring in the NICU: A New Tool for Clinical Care and Research
TLDR
A heart rate characteristics monitor was developed which continuously calculates an HRC index which is the fold-increase in risk that a baby will experience a clinical deterioration consistent with proven or clinical sepsis in the next 24 hours.
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 37 REFERENCES
Toward the early diagnosis of neonatal sepsis and sepsis-like illness using novel heart rate analysis.
TLDR
Newborn infants who had abrupt clinical deterioration as a result of sepsis and sepsi-like illness had abnormal HRC and SNAP that worsened over 24 hours before the clinical suspicion of Sepsis, leading to earlier diagnosis and more effective therapy.
Sample entropy analysis of neonatal heart rate variability.
TLDR
Results show that entropy falls before clinical signs of neonatal sepsis and that missing points are well tolerated, and proposes more informed selection of parameters and reexamination of studies where approximate entropy was interpreted solely as a regularity measure.
Cardiac variability in critically ill adults: Influence of sepsis
ObjectiveTo evaluate, in critically ill adults, factors associated with impaired sympathovagal balance. DesignOne-month inception cohort study. SettingTwenty-six-bed medical intensive care unit of a
Linear and nonlinear analysis of hemodynamic signals during sepsis and septic shock
TLDR
It is concluded that uncoupling of the autonomic and cardiovascular systems occurs over both short- and long-range time scales during sepsis, and the degree of uncoupled may help differentiate between sepsi, septic shock, and recovery states.
Sepsis screen in neonates with evaluation of plasma fibronectin
TLDR
Although clinical judgment should be the primary factor in the decision to institute antibiotic therapy, a simple four-part sepsis screen provides valuable presumptive information for excluding the diagnosis of early onset neonatal sepsi.
The neonatal "sepsis work-up": personal reflections on the development of an evidence-based approach toward newborn infections in a managed care organization.
TLDR
The article describes the results of a pilot study as well as the development and use of a dedicated neonatology outcomes database, the Kaiser Permanente Neonatal Minimum Data Set (NMDS), which includes the Score for Neonatal Acute Physiology and permits ongoing monitoring of sepsis "work-ups" as wellAs confirmed cases of neonatal infection.
Development of a clinical prediction model for an ordinal outcome: the World Health Organization Multicentre Study of Clinical Signs and Etiological agents of Pneumonia, Sepsis and Meningitis in Young Infants. WHO/ARI Young Infant Multicentre Study Group.
TLDR
This paper develops and validate an ordinal predictive model after choosing a data reduction technique, and shows how ordinality of the outcome is checked against each predictor, and describes new but simple techniques for graphically examining residuals from ordinal logistic models to detect problems with variable transformations as well as to detect non-proportional odds and other lack of fit.
...
1
2
3
4
...