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Research Abstracts

Janet T. Ihlenfeld, PhD, RN


SUBTLE HEART RATES ARE PREDICTIVE
OF NEONATAL SEPSIS
Griffin MP, Lake DE, Bissonette EA, Harrell FE Jr,
Oâ Shea TM, Moorman JR. Heart rate characteristics:
Novel physiomarkers to predict neonatal infection and
death. Pediatrics, 2005;116:1070-1074.
Serious infection in newborn infants is one cause of
mortality in that age group. Although sepsis can be
identified by culture and physical symptoms, there
are times when the onset of sepsis is so sudden that efforts
to combat it become futile. This study evaluated an
algorithm that was developed to detect subtle changes
in the heart rate of neonates before the onset of sepsis.
The objective was to try to predict the development
of neonatal sepsis so that interventions can begin
earlier.
In order to evaluate the predictive equation, 1,022
neonates were studied over several years. It was
determined that in these infants, there were 223 cases
of sepsis, 108 urinary tract infections, and 48 deaths
attributed to sepsis. Very low birth weight infants accounted
for 30% of the cases. All infants were observed
for heart rates by continuous monitored heart rate and a
calculated heart rate index.
The findings revealed that subtle changes in the
heart rate in the monitored infants showed up 12 hours
prior to more serious symptoms of sepsis. These heart
rate changes included decelerations and a loss of
variability. The predictive rates of infection were
considered to be high. Higher risk neonates, those who
were premature or who had a low birth weight, were
more likely to be identified as septic from these heart
changes than were low-risk neonates.
The researchers proposed that this assessment of
heart rates would help identify infants who later develop
dangerous sepsis of the neonatal period. These assessments
are easy to perform and have predictive value.
Although there are other reasons why infants develop
sepsis, and presumably other infectious illnesses that
may not cause early heart rate changes, these researchers
are hopeful that some infants can benefit from this new
assessment tool.
CHARACTERISTICS DIFFER ACCORDING
TO REGION IN RATES OF LOW-BIRTH-WEIGHT
INFANTS
Thompson LA, Goodman DC, Chang CH, Stukel TA.
Regional variation in rates of low birth weight. Pediatrics,
2005;116:1114-1121.
Low-birth-weight infants are born on a consistent
basis in the United States despite considerable efforts at
reduction in the numbers. Healthy People 2010 seeks to
reduce low-birth-weight incidences to 5 per 100 live
births by the year 2010; however, there appears to be no
way that this goal can be met.
This research studied the regional characteristics
of all infants born in the United States in 1998.
There were 3,816,535 singleton, non-foreign births
during that year. Data were collected on the following
characteristics:
& Maternal age
& Race
& Hispanic ethnicity
& Completion of high school
& Martial status
& Live birth order
& Maternal weight gain
& Maternal birth place
& Tobacco and alcohol use
& Timing or prenatal care
& Maternal medical risk
& Region of the United States
The data revealed that the overall low-birth-weight
rate in the United States in 1998 was 6.0 per 100 live
births. The results also showed that low-birth-weight
infants continued to be concentrated in black mothers
(11.1/100), those who had gained less than 21 lb (10.9/
100), those who smoked (10.5/100) and/or drank
Research
DIMENSION
July/August 2006 183
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alcohol (12.9/100), teenage mothers (8.5/100), and
those who had low household incomes (7.4/100). In
addition, higher elevation (more than 6,500 ft; 7.7/100)
was also linked to low birth weight. Regional differences
were also found: Those in the west coast and
northeastern part of the United States had lower rates of
low birth weight, whereas the south and western
mountain regions had higher rates.
The researchers stated that the findings show that low
birth weight continues to be a problem in the United
States and that many factors contribute to these statistics.
ABOUT THE AUTHOR
Janet T. Ihlenfeld, PhD, RN, is Professor of Nursing, Dâ Youville
College, Buffalo, NY. Dr Ihlenfeld is a member of the editorial board
for DCCN.
Call for
Student Abstracts
Dimensions of Critical Care Nursing would like to issue a call for abstracts fro
m undergraduate
and graduate nursing students for a new section called, â â Student Abstracts.â â Both
rgraduate
and graduate nursing students in the area of critical care conduct much good
research and I would like to share the results of this research with our readers
. So many times,
the results of this research is presented in the classroom setting and not disse
minated to
others. Here is an opportunity for those students to publish their abstracts.
If you would like to submit your research abstract, you must be either an underg
raduate or
graduate nursing student. Your research must be related to the area of critical
care nursing.
Please submit the following:
Title of the Abstract
Your name and address
School of Nursing
No more than 2 paragraphs summarizing the research and its findings
Please submit the abstract to DCCN at:
Vickie Miracle, RN, EdD
424 Eastgate Village Wynde
Louisville, KY 40223
You could also fax it to 502-253-5560.
You could also e-mail it to vmiracle@aol.com.
Please submit your research and discover the pleasure of publishing.
184 Dimensions of Critical Care Nursing Vol. 25 / No. 4
Research Abstracts
Copyr ight © Lippincott Williams & Wilkins. Unauthorized reproduction of this a
rticle is prohibited.