HEART RATE VARIABILITY IN NEONATAL SEPSIS

本子项目是利用由NIH/NCRR资助的中心赠款提供的资源的众多研究子项目之一。子项目和研究者（PI）可能已经从另一个NIH来源获得了主要资金，因此可以在其他CRISP条目中表示。列出的机构是中心的，不一定是研究者的机构。感染是生命第一个月死亡的一个主要原因，占所有新生儿死亡的13-15%。未经治疗的新生儿败血症死亡率可高达50%。新生儿败血症的早期症状是非特异性的；因此，许多婴儿将接受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是巨大的价值。突出的低频心率振荡，可能与神经自主控制的不稳定有关，在败血症诊断之前经常观察到。我们还观察到，在患有败血症的危重婴儿中，心率和血压变异性的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的丧失（“解耦”）与疾病严重程度的增加和不良结局相关。我们正在开发心率变异性指数，以便早期发现和预测临床恶化，并监测对败血症治疗干预的反应。

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.