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Vital signs and their cross-correlation in sepsis and NEC: a study of 1,065 very-low-birth-weight infants in two NICUs.
- Source :
-
Pediatric research [Pediatr Res] 2017 Feb; Vol. 81 (2), pp. 315-321. Date of Electronic Publication: 2016 Nov 03. - Publication Year :
- 2017
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Abstract
- Background: Subtle changes in vital signs and their interactions occur in preterm infants prior to overt deterioration from late-onset septicemia (LOS) or necrotizing enterocolitis (NEC). Optimizing predictive algorithms may lead to earlier treatment.<br />Methods: For 1,065 very-low-birth-weight (VLBW) infants in two neonatal intensive care units (NICUs), mean, SD, and cross-correlation of respiratory rate, heart rate (HR), and oxygen saturation (SpO <subscript>2</subscript> ) were analyzed hourly (131 infant-years' data). Cross-correlation (cotrending) between two vital signs was measured allowing a lag of ± 30 s. Cases of LOS and NEC were identified retrospectively (n = 186) and vital sign models were evaluated for ability to predict illness diagnosed in the ensuing 24 h.<br />Results: The best single illness predictor within and between institutions was cross-correlation of HR-SpO <subscript>2</subscript> . The best combined model (mean SpO <subscript>2</subscript> , SDHR, and cross-correlation of HR-SpO <subscript>2</subscript> ,) trained at one site with ROC area 0.695 had external ROC area of 0.754 at the other site, and provided additive value to an established HR characteristics index for illness prediction (Net Reclassification Improvement: 0.205; 95% confidence interval (CI): 0.113, 0.328).<br />Conclusion: Despite minor inter-institutional differences in vital sign patterns of VLBW infants, cross-correlation of HR-SpO <subscript>2</subscript> and a 3-variable vital sign model performed well at both centers for preclinical detection of sepsis or NEC.
- Subjects :
- Algorithms
Birth Weight
Electronic Health Records
Enterocolitis, Necrotizing epidemiology
Female
Gestational Age
Heart Rate
Humans
Infant, Newborn
Infant, Premature, Diseases
Infant, Very Low Birth Weight
Intensive Care Units, Neonatal
Intensive Care, Neonatal
Male
Oxygen metabolism
ROC Curve
Respiratory Rate
Retrospective Studies
Risk Factors
Sepsis epidemiology
Time Factors
Vital Signs
Enterocolitis, Necrotizing diagnosis
Sepsis diagnosis
Sepsis physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1530-0447
- Volume :
- 81
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Pediatric research
- Publication Type :
- Academic Journal
- Accession number :
- 28001143
- Full Text :
- https://doi.org/10.1038/pr.2016.215