Interest of RR deceleration for diagnosis of late onset sepsis

Diagnosis of late onset sepsis in premature infants remains difficult because clinical signs are subtle and none of the laboratory tests, including CRP and blood culture, have high predictive accuracy. In this study, we investigate interest of the beat-to-beat Decelerations and Accelerations Runs of n included in [1,20] cycles duration (DR_n and AR_n) counted over periods of 30 minutes. The two hypotheses (H₀: sepsis vs. H₁: non-sepsis) were confronted in a case control study including 16 infected premature infants and 16 non-infected infants. Both groups were seen significantly different mainly on deceleration. Lower DR₁ and higher DR₃, DR₄ values were associated with the sepsis group. We also observed the benefit of the data fusion level. Area under the ROC curves grows up with OR fusion compared to the best local detector. This study confirmed the interest of heart rate variability to reveal infection.