Key result
Early-onset neonatal sepsis links to a ~20% shorter cardiac cycle length compared to controls.
Why the study?
Is early-onset neonatal sepsis associated with altered heart rate variability characteristics in full-term neonates?
Observational (n=40)
Is early-onset neonatal sepsis associated with altered heart rate variability characteristics in full-term neonates?
Early-onset neonatal sepsis is associated with a higher mean heart rate (shorter cardiac cycle length) during automatically selected stationary periods, suggesting potential utility of heart rate monitoring in sepsis detection.
Shorter cardiac cycle length may aid neonatal sepsis surveillance; hypothesis-generating and requires prospective validation before clinical use.
AIM: This study examined the heart rate variability characteristics associated with early-onset neonatal sepsis in a prospective, observational controlled study. METHODS: Eligible patients were full-term neonates hospitalised with clinical signs that suggested early-onset sepsis and a C-reactive protein of >10 mg/L. Sepsis was considered proven in cases of symptomatic septicaemia, meningitis, pneumonia or enterocolitis. Heart rate variability parameters (n = 16) were assessed from five-, 15- and 30-minute stationary sequences automatically selected from electrocardiographic recordings performed at admission and compared with a control group using the U-test with post hoc Benjamini-Yekutieli correction. Stationary sequences corresponded to the periods with the lowest changes of heart rate variability over time. RESULTS: A total of 40 full-term infants were enrolled, including 14 with proven sepsis. The mean duration of the cardiac cycle length was lower in the proven sepsis group than in the control group (n = 11), without other significant changes in heart rate variability parameters. These durations, measured in five-minute stationary periods, were 406 (367-433) ms in proven sepsis group versus 507 (463-522) ms in the control group (p < 0.05). CONCLUSION: Early-onset neonatal sepsis was associated with a high mean heart rate measured during automatically selected stationary periods.
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Nga et al. (2017) conducted an observational in early-onset neonatal sepsis (n=40). Proven early-onset neonatal sepsis vs. control group was evaluated on mean duration of the cardiac cycle length in five-minute stationary periods (p=<0.05). Proven early-onset neonatal sepsis was associated with a lower mean cardiac cycle length compared to controls (406 ms vs 507 ms; p < 0.05) during 5-minute stationary periods.
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