Early‐onset neonatal sepsis is associated with a high heart rate during automatically selected stationary periods

Abstract

International audienceAIM: This study examined the heart rate variability characteristics associated with early-onset neonatal sepsis in a prospective, observational controlled study.METHODS: Eligible patients were full-term neonates hospitalised with clinical signs that suggested early-onset sepsis and a C-reactive protein of >10 mg/L. Sepsis was considered proven in cases of symptomatic septicaemia, meningitis, pneumonia or enterocolitis. Heart rate variability parameters (n = 16) were assessed from five-, 15- and 30-minute stationary sequences automatically selected from electrocardiographic recordings performed at admission and compared with a control group using the U-test with post hoc Benjamini-Yekutieli correction. Stationary sequences corresponded to the periods with the lowest changes of heart rate variability over time.RESULTS: A total of 40 full-term infants were enrolled, including 14 with proven sepsis. The mean duration of the cardiac cycle length was lower in the proven sepsis group than in the control group (n = 11), without other significant changes in heart rate variability parameters. These durations, measured in five-minute stationary periods, were 406 (367-433) ms in proven sepsis group versus 507 (463-522) ms in the control group (p < 0.05).CONCLUSION: Early-onset neonatal sepsis was associated with a high mean heart rate measured during automatically selected stationary periods

Cardiac Function Affection in Infants with Neonatal Sepsis

“…This indicated that both LV and RV systolic and diastolic dysfunction in these infants were more sensitive to detect myocardial dysfunction through conventional echocardiography. A study conducted by Nguyen et al [17] examined the variability in heart rate of the infants that is associated with early onset of neonatal sepsis. The results revealed that early onset of neonatal sepsis have been associated with increased heart rate that is measured during randomly selected stationary periods.…”

Cardiorespiratory Alterations in a Newborn Ovine Model of Systemic Inflammation Induced by Lipopolysaccharide Injection

“…Heart-rate variability reflects the heart's adaptation to internal and external stimuli and is measured by the variation in RR intervals from the ECG signal. Analysis methods of RR interval time series were chosen considering past results on neonatal sepsis (Nguyen et al, 2017). Time-domain analysis of HRV included the mean and standard deviation (SD) of RR duration, an index of global HRV, and the square root of the mean squared differences of successive RR intervals (rMSSD), mainly reflecting parasympathetic control.…”

“…The Poincaré plot further assessed short-term (SD1) and long-term (SD2) HRV. Acceleration capacity (AC) and deceleration capacity (DC) were computed as previously described (Nguyen et al, 2017). The scale invariance (self-similarity of RR time series) was tested through the detrended fluctuation analysis technique, using the fractal scaling exponent α1 (from 4 to 40 beats) (Al-Omar et al, 2019).…”

“…Overall, results showed an increase in both HR and f R with no consistent changes in MAP. Interestingly, tachypnea, tachycardia, and HRV alterations are well-known signs of early-or late-onset sepsis in newborn humans (Griffin et al, 2005;Beuchée et al, 2009;Fairchild, 2013;Bohanon et al, 2015;Kerste et al, 2016;Nguyen et al, 2017;Wu et al, 2017).…”

Cardio-respiratory Events and Inflammatory Response After Primary Immunization in Preterm Infants < 32 Weeks Gestational Age: A Randomized Controlled Study

“…Times between consecutive R waves (RR) (which measures cardiac cycle length) were manually verified. Parameters were selected based on studies showing changes in infants with sepsis (inflammation) or after immunization and were studied as previously reported [7][8][9] . The variables studied were the mean cardiac cycle length (mean), the standard deviation (SD) which measures the magnitude of global heart rate variability, and the square root of the mean squared differences of successive RR intervals (rMSSD; short-term beat-to-beat variability which reflects parasympathetic control).…”