Background Sepsis remains the largest preventable source of neonatal mortality in the world. Heart rate variability (HRV) analysis and noninvasive cardiac output, have been shown to be useful adjuncts to sepsis detection in many patient groups. Methods With IRB approval, 4 septic and 6 nonseptic ELBW patients were enrolled. Data from septic and healthy patients were collected for 5 hours. ECG waveform and traditional vital signs were collected and the RR intervals were calculated, then heart rate variability analysis was performed in both the time- and frequency-domain. Results HRV measurements in time-domain, HR, and Sp02 were significantly different in septic patients vs. nonseptic controls Conclusion These results indicate that nonconventional vital signs such as HRV are more sensitive than traditionally used vital signs, such as CO and MAP, in the confirmation of sepsis in ELBW neonates. HRV may allow for earlier identification of septic physiology.

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