Saving babies from sepsis

Infant's risk of death cut by 20 percent

CHARLOTESVILLE, VA (Ivanhoe Newswire) - One in four babies will develop it and it can kill them. By the time doctors spot sepsis in newborns it can already be too late.

For new parents Michael and Shelly, little Kinley came as a surprise.

"We weren’t trying or anything," said Shelly.

Another surprise, Kinley was born four months early weighing just one pound, five ounces.

"It was all new, I didn’t know what to expect," said Michael.

Kinley was at high risk for sepsis, a severe blood infection that can spread throughout the body.

"If we detect it late it can be very, very damaging and even fatal." Karen Fairchild, M.D., a Neonatologist at the University of Virginia Health System, explained.

But finding the infection before it’s too late can be tough. "Once the baby shows signs of sepsis, they may already be very, very sick," Dr. Fairchild said.

Doctors at the University of Virginia developed the HeRO monitor to help pick up on the subtle signs early.

"I really think this is revolutionary," Dr. Fairchild said.

Every hour it identifies changes in babies’ heart rate patterns that happen early in sepsis, then creates a score from zero to seven.

"If your HeRO score is 1 you have exactly the average rate of illness.

If your HeRO score is 2 you have twice the risk, if it’s 3 you have three times the risk," Randall Moorman, M.D., a cardiologists at the University of Virginia Health System, explained.

In a study of 3,000 infants, those on the HeRO monitor had their risk of death cut by 20 percent. Kinley’s score was as high as five.

She was given antibiotics and now all this new mom and dad have to worry about is parenthood.

Researchers at UVA have been working on the HeRO monitor for more than ten years and it’s now being used in a handful of neonatal intensive care units around the country.

BACKGROUND:

Sepsis is a potentially life-threatening complication of an infection. While sepsis can happen to anyone, it's most common and most dangerous in people who are elderly or who have weakened immune systems. Sepsis occurs when chemicals released into the bloodstream to fight the infection trigger inflammation throughout the body. This inflammation creates microscopic blood clots that can block nutrients and oxygen from reaching organs, causing them to fail. If sepsis progresses to septic shock, blood pressure drops dramatically and the person may die. (Source: Mayo Clinic)

SEPSIS AND NEWBORNS:

One in four babies will develop it and in newborns, it can be life-threatening. A number of different bacteria, including Escherichia coli (E.coli), Listeria, and certain strains of streptococcus, may cause neonatal sepsis. Neonatal sepsis may be categorized as early-onset or late-onset. Of newborns with early-onset sepsis, 85% present within 24 hours, 5% present at 24-48 hours, and a smaller percentage present within 48-72 hours. Onset is most rapid in premature newborns. Early-onset sepsis is associated with acquisition of microorganisms from the mother. Transplacental infection or an ascending infection from the cervix may be caused by organisms that colonize the mother’s genitourinary (GU) tract; the neonate acquires the microorganisms as it passes through the colonized birth canal at delivery. (Source: Medscape) Babies with late-onset neonatal sepsis get infected after delivery. The following increase an infant's risk of sepsis after delivery:

  • Having a catheter in a blood vessel for a long time
  • Staying in the hospital for an extended period of time

The signs of sepsis are non-specific and include: lethargy, a poor cry, poor feeding, fever, jaundice, poor perfusion, sclerema, poor weight gain, renal failure, cyanosis, tachypnea, chest retractions, grunt, apnea/gasping, fever, seizures, a blank look, high pitched cry, excessive crying/irritability, neck retraction, bulging fontanelle and seizures. A heart rate above 160 can also be an indicator of sepsis, this tachycardia can present up to 24 hours before the onset of other signs. (Source: MedlinePlus)

NEW TECHNOLOGY:

Researchers at UVA developed the Heart Rate Observation System (HeRO monitor), which uses information gathered from the heart rate monitor to determine shifts in the heart rate on a continual basis. HeRO generates an hourly numeric score that quantifies the prevalence of abnormal patterns in each patient's heart rate. It provides real time display of the HeRO Score at multiple viewing stations located throughout the NICU. It’s is non-invasive and requires no applied parts or new patient leads. Without the HeRO monitor, doctors and nurses have to rely on their own observations to detect early warning signs. (Source: Heroscore.com, UVA)

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