Septicemia mortality reduction in neonates in a heart rate characteristics monitoring trial.
Septicemia mortality reduction in neonates in a heart rate characteristics monitoring trial.
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DOI：
10.1038/pr.2013.136
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发表时间：
2013-11
影响因子：
3.6
通讯作者：
Moorman, J. Randall
中科院分区：
文献类型：
--
作者：
Fairchild, Karen D.;Schelonka, Robert L.;Kaufman, David A.;Carlo, Waldemar A.;Kattwinkel, John;Porcelli, Peter J.;Navarrete, Cristina T.;Bancalari, Eduardo;Aschner, Judy L.;Walker, M. Whit;Perez, Jose A.;Palmer, Charles;Lake, Douglas E.;O'Shea, T. Michael;Moorman, J. Randall
新生儿重症监护病房 (NICU) 患者的培养阳性迟发性败血症 (LOS) 早期阶段的异常心率特征 (HRC) 时好时坏。持续监测 HRC 指数可降低极低出生体重 (VLBW) 婴儿的死亡率。我们假设死亡率的降低是由于败血症相关死亡率的降低。这是对 2989 名极低出生体重婴儿的临床和 HRC 数据进行的二次分析，这些婴儿参加了 2004 年至 2010 年在 9 个 NICU 进行的 HRC 监测随机对照试验。 700 名患者中 LOS 被诊断出 974 次，HRC 显示组和非显示组中微生物的发生率和分布相似。与非显示组相比，HRC 显示组 LOS 30 天内的死亡率较低（11.8% vs 19.6%，RR 0.61，95% CI 0.43、0.87，p<0.01），但对于没有 LOS 的患者，死亡率降低没有统计学意义。在显示 HRC 指数的婴儿中，在 LOS 诊断前几天，HRC 指数大幅突然增加的情况较少。连续 HRC 监测与极低出生体重婴儿败血症相关死亡率较低相关，这可能是由于病程早期诊断所致。
Abnormal heart rate characteristics (HRC) wax and wane in early stages of culture-positive, late-onset septicemia (LOS) in patients in the neonatal intensive care unit (NICU). Continuously monitoring an HRC index leads to a reduction in mortality among very low birth weight (VLBW) infants. We hypothesized that the reduction in mortality was due to a decrease in septicemia-associated mortality. This is a secondary analysis of clinical and HRC data from 2989 VLBW infants enrolled in a randomized controlled trial of HRC monitoring in 9 NICUs from 2004–2010. LOS was diagnosed 974 times in 700 patients, and the incidence and distribution of organisms were similar in HRC display and non-display groups. Mortality within 30 days of LOS was lower in the HRC display compared to the non-display group (11.8% vs 19.6%, RR 0.61, 95% CI 0.43, 0.87, p<0.01), but mortality reduction was not statistically significant for patients without LOS. There were fewer large, abrupt increases in the HRC index in the days leading up to LOS diagnosis in infants whose HRC index was displayed. Continuous HRC monitoring is associated with a lower septicemia-associated mortality in VLBW infants, possibly due to diagnosis earlier in the course of illness.
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影响因子：
4.6
作者：
Moorman, JR;Lake, DE;Griffin, MP
通讯作者：
Griffin, MP
影响因子：
3.6
作者：
Griffin, MP;O'Shea, TM;Moorman, JR
通讯作者：
Moorman, JR
影响因子：
8
作者：
Griffin, MP;Lake, DE;Moorman, JR
通讯作者：
Moorman, JR
影响因子：
8
作者：
Griffin, MP;Lake, DE;Moorman, JR
通讯作者：
Moorman, JR
影响因子：
8
作者：
Griffin, MP;Moorman, JR
通讯作者：
Moorman, JR