Central-peripheral temperature gradient: an early diagnostic sign of late-onset neonatal sepsis in very low birth weight infants
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José Luis Leante-Castellanos
,
José M. Lloreda-García
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 g or <32 weeks) participated in an observational prospective study. Axillary (central) and sole (peripheral) temperatures were continuously monitored with a thermal probe (ThermoTracer; Dräger Medical AGF & Co. KgaA, Lübeck, Germany) adjusting incubator air temperature for a thermal gradient <1.5°C. Central-peripheral temperature alteration was defined as a thermal gradient >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.
©2012 by Walter de Gruyter Berlin Boston
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Artikel in diesem Heft
- Masthead
- Masthead
- Original Articles – Obstetrics
- Intravenous iron treatment in pregnancy: comparison of high-dose ferric carboxymaltose vs. iron sucrose
- Trophoblastic progranulin expression is upregulated in cases of fetal growth restriction and preeclampsia
- Can a customized standard for large for gestational age identify women at risk of operative delivery and shoulder dystocia?
- Can discordance in CRL at the first trimester predict birth weight discordance in twin pregnancies?
- Anxiety and deterioration of quality of life factors associated with recurrent miscarriage in an observational study
- Neonatal outcome in infants of patients with radical vaginal trachelectomy
- The prevalence of gestational diabetes in advanced economies
- First-trimester reference ranges for decidual thickness and its relation to progesterone levels
- Original Articles – Fetus
- Levels of cytokines in umbilical cord blood in relation to spontaneous term labor
- Survival and neonatal outcome after fetoscopic guided laser occlusion (FLOC) of twin-to-twin transfusion syndrome (TTTS) in Sweden
- Is it necessary to induce labor in cases of intrauterine growth restriction at term?
- Fetal myocardial peak systolic strain before and after intrauterine red blood cell transfusion – a tissue Doppler imaging study
- Delayed interval delivery in twin and triplet pregnancies: 6 years of experience in one perinatal center
- Original Articles – Newborn
- Rapid neonatal weight gain increases risk of childhood overweight in offspring of diabetic mothers
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