lunes, 17 de septiembre de 2012

Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants

Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants

Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants

1 / Lloreda-García, José M.1 / García-González, Ana1 / Llopis-Baño, Caridad1 / Fuentes-Gutiérrez, Carmen1 / Alonso-Gallego, José Ángel1 / Martínez-Gimeno, Antonio1
1Section of Neonatology, Service of Pediatrics, Hospital General Universitario Santa Lucía, Cartagena, Murcia, Spain
Corresponding author: José Luis Leante-Castellanos Neonatology Unit Hospital General Universitario Santa Lucía C/Mezquita–Paraje Los Arcos E-30202 Santa Lucía Cartagena Spain Tel.: +34 968128600 Fax: +34 968128646
Citation Information: . Volume 40, Issue 5, Pages 571–576, ISSN (Online) 1619-3997, ISSN (Print) 0300-5577, DOI: 10.1515/jpm-2011-0269, April 2012
Publication History:
Received:
2011-10-28
Revised:
2012-03-29
Accepted:
2012-03-30
Published Online:
2012-04-22

Abstract

Aims: We assessed central-peripheral temperature gradient alteration for the diagnosis of late-onset neonatal sepsis and compared earliness detection of this sign with altered blood cell count and C-reactive protein.
Method: Thirty-one preterm babies (<1500 a="a" adjusting="adjusting" agf="agf" air="air" alteration="alteration" amp="amp" an="an" and="and" as="as" axillary="axillary" beck="beck" central-peripheral="central-peripheral" central="central" co.="co." continuously="continuously" defined="defined" dr="dr" for="for" g="g" ger="ger" germany="germany" gradient="gradient" hermotracer="hermotracer" in="in" incubator="incubator" kgaa="kgaa" l="l" medical="medical" monitored="monitored" observational="observational" or="or" participated="participated" peripheral="peripheral" probe="probe" prospective="prospective" sole="sole" study.="study." temperature="temperature" temperatures="temperatures" thermal="thermal" was="was" weeks="weeks" were="were" with="with">2°C that could not be corrected with protocolized air temperature modifications. Proven (positive blood culture) sepsis and probable late-onset sepsis were recorded.
Results: Late-onset sepsis was diagnosed in 11 neonates (proven, 9; probable, 2). Thermal gradient alteration was present in 12 cases, in association with the onset of sepsis in 10 and concomitantly with a ductus arteriosus and stage 1 necrotizing enterocolitis in 2. Thermal gradient alteration had a sensitivity of 90.9% [95% confidence interval (CI), 62.3–98.4] and specificity of 90% (95% CI, 69.9–97.2%), and in 80% of cases, it occurred before abnormal laboratory findings.
Conclusions: Central-peripheral temperature gradient monitoring is a feasible, non-invasive, and simple tool easily applicable in daily practice. An increase of >2°C showed a high-sensitivity and specificity for the diagnosis of late-onset sepsis.
Keywords (MeSH terms): Body temperature regulation; infant, premature; infection/diagnosis; prospective studies; sepsis/diagnosis

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