HEART RATE VARIABILITY IN NEONATAL SEPSIS

该子项目是利用NIH/NCRR资助的中心赠款提供的资源的许多研究子项目之一。子项目和研究者（PI）可能从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。所列机构为中心，不一定是研究者所在机构。感染是生命第一个月内死亡的主要原因，占所有新生儿死亡的13-15%。新生儿败血症的死亡率可能高达50%的婴儿谁不治疗。新生儿败血症的早期体征是非特异性的;因此，许多婴儿将进行诊断研究，并在诊断确定之前开始治疗。更好的诊断工具，可以提供及时和准确的诊断新生儿败血症将具有巨大的价值。在脓毒症诊断之前，经常观察到明显的低频心率振荡，这可能与神经自主控制的不稳定有关。我们还观察到，心率和血压变异性降低，表明神经自主神经系统和心血管系统之间的相互联系丧失（“解偶联”），与败血症重症婴儿的疾病严重程度增加和预后不良相关。我们正在开发心率变异性指数，以便早期检测和预测临床恶化，并监测脓毒症治疗中对治疗干预的反应。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Infection is a major cause of death during the first month of life, contributing to 13-15% of all neonatal deaths. Mortality for neonatal sepsis may be as high as 50% for infants who are not treated. The early signs of sepsis in the newborn are nonspecific; therefore, many infants will undergo diagnostic studies and the initiation of treatment before the diagnosis has been determined. Better diagnostic tools that can provide timely and accurate diagnosis of neonatal sepsis will be of tremendous value. Prominent low-frequency heart rate oscillations, which could be related to the instability of neuroautonomic control, have been often observed prior to the diagnosis of sepsis. We have also observed that decreased heart rate and blood pressure variability, indicative of a loss of interconnections ("uncoupling"), between the neuroautonomic and cardiovascular systems correlate with increased severity of illness and less favorable outcome in critically ill infants with sepsis. We are developing heart rate variability indices that allow for early detection and prediction of clinical deterioration and monitoring the response to therapeutic intervention in the treatment of sepsis.