Infection detection: Saving babies from sepsis
BACKGROUND: Sepsis is a potentially life-threatening complication of an infection. While sepsis can happen to anyone, it's most common and most dangerous in people who are elderly or who have weakened immune systems. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body. This inflammation creates microscopic blood clots that can block nutrients and oxygen from reaching organs, causing them to fail. If sepsis progresses to septic shock, blood pressure drops dramatically and the person may die. (Source: Mayo Clinic)
SEPSIS AND NEWBORNS: One in four babies will develop it and in newborns, it can be life-threatening. A number of different bacteria, including Escherichia coli (E.coli), Listeria, and certain strains of streptococcus, may cause neonatal sepsis. Neonatal sepsis may be categorized as early-onset or late-onset. Of newborns with early-onset sepsis, 85% present within 24 hours, 5% present at 24-48 hours, and a smaller percentage present within 48-72 hours. Onset is most rapid in premature newborns. Early-onset sepsis is associated with acquisition of microorganisms from the mother. Transplacental infection or an ascending infection from the cervix may be caused by organisms that colonize the mother’s genitourinary (GU) tract; the neonate acquires the microorganisms as it passes through the colonized birth canal at delivery. (Source: Medscape)
Babies with late-onset neonatal sepsis get infected after delivery. The following increase an infant's risk of sepsis after delivery:
- Having a catheter in a blood vessel for a long time
- Staying in the hospital for an extended period of time
The signs of sepsis are non-specific and include: lethargy, a poor cry, poor feeding, fever, jaundice, poor perfusion, sclerema, poor weight gain, renal failure, cyanosis, tachypnea, chest retractions, grunt, apnea/gasping, fever, seizures, a blank look, high pitched cry, excessive crying/irritability, neck retraction, bulging fontanelle and seizures. A heart rate above 160 can also be an indicator of sepsis, this tachycardia can present up to 24 hours before the onset of other signs. (Source: MedlinePlus)
NEW TECHNOLOGY: Researchers at UVA developed the Heart Rate Observation System (HeRO monitor), which uses information gathered from the heart rate monitor to determine shifts in the heart rate on a continual basis. HeRO generates an hourly numeric score that quantifies the prevalence of abnormal patterns in each patient's heart rate. It provides real time display of the HeRO Score at multiple viewing stations located throughout the NICU. It’s is non-invasive and requires no applied parts or new patient leads. Without the HeRO monitor, doctors and nurses have to rely on their own observations to detect early warning signs. (Source: Heroscore.com, UVA)
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