Sepsis Monitoring System May Predict Sepsis in Newborns
A multicenter clinical trial is examining the effectiveness of a bedside monitoring system developed by University of Virginia Children's Hospital researchers to predict the likelihood a baby will develop sepsis.
Most newborns have heart-rate fluctuations, says Randall Moorman, M.D., a UVa cardiologist and co-developer of the monitoring system with former UVa neonatologist Pam Griffin. Studies of the heart-rate characteristics of neonatal babies, especially those weighing less than 1,500 grams, found a pronounced decrease in the level of heart-rate fluctuations, along with brief episodes of slowing heart rates, before early clinical signs the babies had developed sepsis.
Those studies were used by UVa researchers and mathematicians to develop an algorithm that predicts the clinical onset of sepsis up to 12 hours before symptoms appear.
"The system gives us a continuous bedside display of risk status as generated by a computer analysis of the patient's heart-rate characteristics. It's this constant readout of risk status that makes the system so valuable to clinicians," says UVa neonatologist John Kattwinkel, M.D.
Mortality rates are two to three times higher for babies that develop sepsis, Moorman says, and their rate of neurological development impairment in is 30 percent to 50 percent greater. Moorman hopes the clinical trial will help answer whether early intervention saves lives and reduces developmental issues, such as cerebral palsy, in neonatal babies whose sepsis is diagnosed earlier.
"Although it seems evident that earlier detection of sepsis would be good, we also need to know if the system may cause us to treat with antibiotics inappropriately in babies who may not have sepsis," Kattwinkel says.
The sepsis monitoring system is the latest treatment advance for newborns at UVa, which operates a 45-bed Level III Newborn Intensive Care Unit to provide the highest level of care for at-risk infants. UVa is a hub for a regional neonatal treatment system and a referral center for hospitals around the region, with consultations available 24 hours a day.
UVa Children's Hospital provides comprehensive services to newborns, including heart-lung bypass surgery for life-threatening congenital conditions and a mobile NICU to transport babies to and from UVa.
To refer a patient to the NICU, call UVa Physician Direct at 800-552-3723.