Original ArticleHemodynamics in Preterm Infants with Late-Onset Sepsis
Section snippets
Methods
We performed an observational cohort study in the neonatal intensive care unit of Emma Children's Hospital, Academic Medical Centre, Amsterdam, the Netherlands, between November 2006 and January 2008, and the John Hunter Hospital, Newcastle, Australia, between August 2008 and September 2009. The study was approved by the local ethics committees, and informed consent was obtained from the parents.
Infants <34 weeks gestation with a suspected infection after 72 hours of life were eligible. The
Results
During the study periods, 318 preterm infants <34 weeks gestation were admitted to the unit in Amsterdam, and 257 were admitted in Newcastle. Late onset clinical sepsis developed in 78 infants (13.5%), and treatment was started. Twenty-seven of these infants (4.7%) were eligible for inclusion in the study and had ≥2 predefined signs of hemodynamic disturbance. Seven eligible infants were not examined because the investigator was not available.
Twenty infants with a median gestational age of 27
Discussion
Preterm infants with sepsis after initial volume support have relatively high left and right cardiac outputs and low SVR, similar to the adult with sepsis.
A recent prospective study of 30 children with fluid resistant shock admitted to the pediatric intensive care unit showed that children who had hospital-acquired catheter-associated sepsis had a high cardiac index and low SVR. This pattern was not seen in community-acquired sepsis, in which a normal or low cardiac index was predominant.10 Our
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The authors declare no conflicts of interest.