Meningitis, urinary tract, and bloodstream infections in very low birth weight infants enrolled in a heart rate characteristics monitoring trial

Weitkamp, Jörn-Hendrik; Aschner, Judy L.; Carlo, Wallly A.; Bancalari, Eduardo; Pérez, José A.; Navarrete, Cristina T.; Schelonka, Robert L.; Walker, M W; Porcelli, Peter J.; Palmer, Charles; Grossarth, Sarah; Lake, Douglas E.; Fairchild, Karen D.

doi:10.1038/s41390-019-0701-4

Cited by 14 publications

(8 citation statements)

References 19 publications

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“…Subtle changes can occur before overt clinical signs of illness, prompting development of early warning systems that alert clinicians to changes in patient status requiring attention (2)(3)(4). One example is the finding of abnormal heart rate characteristics of decreased variability and transient repetitive decelerations that sometimes precede clinical presentation of sepsis, necrotizing enterocolitis (NEC), or other infections in very low birth weight (VLBW) preterm infants (5)(6)(7)(8)(9).…”

Section: Introductionmentioning

confidence: 99%

Vital sign metrics of VLBW infants in three NICUs: implications for predictive algorithms

et al. 2021

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Background: Continuous heart rate (HR) and oxygenation (SpO 2 ) metrics can be useful for predicting adverse events in very low birth weight (VLBW) infants. To optimize the utility of these tools, inter-site variability must be taken into account. Methods:For VLBW infants at three NICUs, we analyzed the mean, standard deviation, skewness, kurtosis, and cross-correlation of electrocardiogram HR, pulse oximeter pulse rate, and SpO 2 . The number and durations of bradycardia and desaturation events were also measured. Twenty-two metrics were calculated hourly, and mean daily values were compared between sites. Results:We analyzed data from 1,168 VLBW infants from birth through day 42 (35,238 infant days). HR and SpO 2 metrics were similar at the three NICUs, with mean HR rising by ~10 beats/minute over the first two weeks and mean SpO 2 remaining stable around 94% over time. The number of bradycardia events was higher at one site, and the duration of desaturations was longer at another site.Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use:http://www.nature.com/authors/editorial_policies/license.html#terms

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Section: Introductionmentioning

confidence: 99%

Vital sign metrics of VLBW infants in three NICUs: implications for predictive algorithms

et al. 2021

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“…In preterm neonates, changes in heart rate variability (HRV) can allow early detection of sepsis before clinical deterioration, facilitating earlier treatment and improved survival 13 – 16 . The key heart rate features of neonatal infection include asymmetrical heart rate traces, reduced time domain measures of HRV, with reduced sample entropy and measures of nonlinear HRV 13 , 15 , 17 . The combined analysis of these measures into a single score called the heart rate characteristic index has recently been reported to have an overall sensitivity of 53% and specificity of 80% for culture-proven late-onset neonatal sepsis across all gestational ages 18 .…”

Section: Introductionmentioning

confidence: 99%

Fetal heart rate variability is a biomarker of rapid but not progressive exacerbation of inflammation in preterm fetal sheep

Magawa

Lear

Beacom

et al. 2022

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Perinatal infection/inflammation can trigger preterm birth and contribute to neurodevelopmental disability. There are currently no sensitive, specific methods to identify perinatal infection. We investigated the utility of time, frequency and non-linear measures of fetal heart rate (FHR) variability (FHRV) to identify either progressive or more rapid inflammation. Chronically instrumented preterm fetal sheep were randomly assigned to one of three different 5d continuous i.v. infusions: 1) control (saline infusions; n = 10), 2) progressive lipopolysaccharide (LPS; 200 ng/kg over 24 h, doubled every 24 h for 5d, n = 8), or 3) acute-on-chronic LPS (100 ng/kg over 24 h then 250 ng/kg/24 h for 4d plus 1 μg boluses at 48, 72, and 96 h, n = 9). Both LPS protocols triggered transient increases in multiple measures of FHRV at the onset of infusions. No FHRV or physiological changes occurred from 12 h after starting progressive LPS infusions. LPS boluses during the acute-on-chronic protocol triggered transient hypotension, tachycardia and an initial increase in multiple time and frequency domain measures of FHRV, with an asymmetric FHR pattern of predominant decelerations. Following resolution of hypotension after the second and third LPS boluses, all frequencies of FHRV became suppressed. These data suggest that FHRV may be a useful biomarker of rapid but not progressive preterm infection/inflammation.

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“…The total mortality and morbidity rates due to neonatal sepsis were estimated at 27.4% and 89.3%, respectively. [15][16][17] From the available data, it was found that the majority of patients had low birth weight and were preterm.…”

Section: Resultsmentioning

confidence: 99%

The Relationship between Accurate Use of Antibiotics and Clinical Improvement of Sepsis in Neonates Using the Gyssens Method in the Perinatology Ward of Dr. M. Djamil General Hospital, Padang Indonesia

2022

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Background: Neonatal sepsis is a major cause of neonatal morbidity and mortality in developing countries. Inappropriate use of antibiotics causes an increase in antibiotic resistance, so the Gyssens method is needed, which is a qualitative method and is used to evaluate the use of antibiotics. This study aims to determine the relationship between the accuracy of the use of antibiotics using the Gyssens method on the clinical improvement of neonates in the Perinatology Ward of Dr. M. Djamil General Hospital Padang, Indonesia. Methods: This study used a cross-sectional conducted from January 2020 to December 2020. The study subjects were 67 neonates diagnosed with sepsis in the perinatology ward of Dr. M. Djamil General Hospital, Padang Indonesia. Data analysis was performed with SPSS for univariate and bivariate analysis. Results: Most neonatal sepsis occurs in male infants who have low birth weight. Most cultures do not grow. There was an improvement in clinical and hematological parameters to the administration of first-line, second-line, and culture-appropriate antibiotics according to the Gyssens method, but statistically not significant (p-value > 0.05). The rational use of antibiotics was 89.6%. Conclusion: There is a relationship between the accuracy of antibiotic use on clinical improvement and blood parameters of neonatal sepsis patients in the Perinatology ward of Dr. M. Djamil General Hospital based on the Gyssens method, but it is not statistically significant. The use of antibiotics based on the Gyssens method at Dr. M. Djamil General Hospital is quite good.

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Meningitis, urinary tract, and bloodstream infections in very low birth weight infants enrolled in a heart rate characteristics monitoring trial

Cited by 14 publications

References 19 publications

Vital sign metrics of VLBW infants in three NICUs: implications for predictive algorithms

Vital sign metrics of VLBW infants in three NICUs: implications for predictive algorithms

Fetal heart rate variability is a biomarker of rapid but not progressive exacerbation of inflammation in preterm fetal sheep

The Relationship between Accurate Use of Antibiotics and Clinical Improvement of Sepsis in Neonates Using the Gyssens Method in the Perinatology Ward of Dr. M. Djamil General Hospital, Padang Indonesia

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