Document Detail


Cardiovascular oscillations at the bedside: early diagnosis of neonatal sepsis using heart rate characteristics monitoring.
MedLine Citation:
PMID:  22026974     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have applied principles of statistical signal processing and nonlinear dynamics to analyze heart rate time series from premature newborn infants in order to assist in the early diagnosis of sepsis, a common and potentially deadly bacterial infection of the bloodstream. We began with the observation of reduced variability and transient decelerations in heart rate interval time series for hours up to days prior to clinical signs of illness. We find that measurements of standard deviation, sample asymmetry and sample entropy are highly related to imminent clinical illness. We developed multivariable statistical predictive models, and an interface to display the real-time results to clinicians. Using this approach, we have observed numerous cases in which incipient neonatal sepsis was diagnosed and treated without any clinical illness at all. This review focuses on the mathematical and statistical time series approaches used to detect these abnormal heart rate characteristics and present predictive monitoring information to the clinician.
Authors:
J Randall Moorman; John B Delos; Abigail A Flower; Hanqing Cao; Boris P Kovatchev; Joshua S Richman; Douglas E Lake
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2011-10-25
Journal Detail:
Title:  Physiological measurement     Volume:  32     ISSN:  1361-6579     ISO Abbreviation:  Physiol Meas     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-10-26     Completed Date:  2012-02-24     Revised Date:  2013-12-05    
Medline Journal Info:
Nlm Unique ID:  9306921     Medline TA:  Physiol Meas     Country:  England    
Other Details:
Languages:  eng     Pagination:  1821-32     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Computer Simulation
Early Diagnosis
Electrocardiography, Ambulatory
Entropy
Heart Rate
Humans
Infant, Newborn
Infant, Newborn, Diseases / blood,  diagnosis*,  physiopathology*
Infant, Premature, Diseases / diagnosis*,  physiopathology*
Models, Statistical
Nonlinear Dynamics
Point-of-Care Systems*
Sepsis / blood,  diagnosis*,  physiopathology*
Grant Support
ID/Acronym/Agency:
R01 GM064640/GM/NIGMS NIH HHS; R01 HD048562/HD/NICHD NIH HHS; RC2 HD064488/HD/NICHD NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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