Hero: Not just for infections any more

Sullivan BA, Grice SM, Lake DE, Moorman JR, Fairchild KD. Infection and Other Clinical Correlates of Abnormal Heart Rate Characteristics in Preterm Infants. The Journal of pediatrics. 2014. Monitoring for abnormal heart rate characteristics has previously been shown in a randomized trial to reduce mortality. Infants who are developing sepsis have a reduced baseline heart rate variability with more episodic decelerations, leading to earlier detection and treatment.  This new study looked at other clinical complications which were associated with an increase in the score that the monitor calculates. A spike in the score to more than 3 above the previous 5 days average was associated with  noted. The score relates to the relative risk of developing sepsis in the next 24 hours. In addition to sepsis, increases in the score were seen within 24 hours of sepsis, with urinary tract infections, with necrotising enterocolitis, and with respiratory deteriorations (a 50% increase in apneas, O2 needs and/or ventilatory requirements). They also increased after surgery.

So if (or when) you have this technology, you can be a bit skeptical if the baby just had surgery, and make sure you evaluate for NEC and UTI as well as sepsis.

About keithbarrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
This entry was posted in Neonatal Research and tagged , . Bookmark the permalink.

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