Heart rate characteristics and clinical signs in neonatal sepsis
Heart rate characteristics and clinical signs in neonatal sepsis
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DOI：
10.1203/01.pdr.0000252438.65759.af
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发表时间：
2007-02-01
影响因子：
3.6
通讯作者：
Moorman, J. Randall
中科院分区：
文献类型：
--
作者：
Griffin, M. Pamela;Lake, Douglas E.;Moorman, J. Randall
为了验证心率特征(HRC)监测在诊断新生儿败血症中增加临床症状信息的假设，我们前瞻性地记录了弗吉尼亚大学NICU 7d以上的337例婴儿中76例确诊为败血症和80例临床败血症的临床数据和HRC指数。我们根据与脓毒症相关的临床结果和测试设计了疾病严重程度评分。得分来源于多变量回归模型的系数，我们对总分进行了内部验证。我们确定了HRC指数与个别临床体征、实验室检查和总分的关系。我们发现临床评分和个人临床体征与HRC指数具有高度显著的相关性。临床评分和HRC指数在预测脓毒症方面增加了独立的信息，在临床和已证实的脓毒症中相似。临床评分和HRC指数在脓毒症前升高，且HRC指数最先上升。我们得出结论，在新生儿败血症的诊断中，临床症状和HRC监测相互补充独立的信息。
To test the hypothesis that heart rate characteristic (HRC) monitoring adds information to clinical signs of illness in diagnosing neonatal sepsis, we prospectively recorded clinical data and the HRC index in 76 episodes of proven sepsis and 80 episodes of clinical sepsis in 337 infants in the University of Virginia NICU more than 7 d old. We devised an illness severity score based on clinical findings and tests relevant to sepsis. Point scores were derived from coefficients of multivariable regression models, and we internally validated a total score. We determined relationships of the HRC index with individual clinical signs, laboratory tests, and the total score. We found highly significant correlations of the clinical score and individual clinical signs with the HRC index. The clinical score and HRC index added independent information in predicting sepsis, and were similar in clinical and proven sepsis. The clinical score and the HRC index rose before sepsis, and the HRC index rose first. We conclude that clinical signs of illness and HRC monitoring add independent information to one another in the diagnosis of neonatal sepsis.