Advancements in understanding the association of sepsis with heart rate variability in premature infants

• Published in: The Gazette of the Egyptian Paediatric Association Vol. 72; no. 1; pp. 37 - 8
• Main Authors: Chi, Di, Guo, Wanxu, Liu, Junjiao, Gao, Wenhui, Wang, Yuan, Zhang, Yunfeng
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-12-2024; Springer; Springer Nature B.V; SpringerOpen
• Subjects: Antibiotics; Bacteria; Birth weight; Diseases; Drug resistance; Early diagnosis of sepsis; Gestational age; Health aspects; Heart; Heart beat; Heart rate; Heart rate variability monitoring; Infants; Infants (Newborn); Infants (Premature); Infections; Medicine; Medicine & Public Health; Mortality; Neonatal sepsis; Neonatology; Nervous system; Newborn babies; Patient outcomes; Pediatrics; Poisoning; Prediction of sepsis; Premature babies; Premature birth; Prognosis; Review; Sepsis; Early diagnosis of sepsis; Prediction of sepsis; Heart rate variability monitoring; Neonatal sepsis
• ISSN: 1110-6638; 2090-9942
• DOI: 10.1186/s43054-024-00278-y

Background
With the rapid development of perinatal medicine and neonatal resuscitation technology, neonatal mortality gradually reduces, but sepsis is still a neonatal critical illness and an important cause of death. The onset of sepsis in premature infants is insidious, and the clinical symptoms lack of specificity. The available laboratory tests exhibit limited sensitivity and specificity for diagnosis, and there is a certain degree of time lag. Therefore, it is particularly important to find a method for early detection of severe infection in premature infants.
Main body
Sepsis is the third leading cause of death with poor prognosis in infants. Early and accurate identification of sepsis are particularly important. Heart rate variability may present before clinical symptoms of sepsis. The study is to summarize the available data on the relationship between heart rate variability and development of sepsis in early infants.
We searched six database, PubMed, Web of Science, Embase, Cochrane Library, Wanfang, and CNKI, using the following terms for our search strategy (Infants, Newborn) OR (Newborn Infant) OR (Newborn Infants) OR (Newborns) OR (Newborn) OR (Neonate) OR (Neonates) AND (Sepsis) OR (Bloodstream Infection) OR (Bloodstream Infections) OR (Pyemia) OR (Pyemias) OR (Pyohemia) OR (Pyohemias) OR (Pyaemia) OR (Pyaemias) OR (Septicemia) OR (Septicemias) OR (Blood Poisoning) OR (Blood Poisonings) OR (Severe Sepsis) OR (Sepsis, Severe) AND (Heart Rate Variability). Premature infants would experience the reduction in heart rate variability before clinical symptoms of sepsis present.
Conclusion
The application of heart rate variability, a noninvasive monitoring method, to the identification and diagnosis of sepsis in premature infants can enable clinicians to identify, diagnose, and treat children with sepsis early, thereby reducing the mortality of premature infants and neurological damage.