RESUMO
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Assuntos
Humanos , Feminino , Recém-Nascido , Anemia Neonatal/complicações , Epilepsias Mioclônicas/genética , Deficiência de Vitamina B 6/genética , Piridoxina/uso terapêutico , Convulsões/genética , Epilepsia/genética , Transfusão de Sangue IntrauterinaAssuntos
Anormalidades Múltiplas/genética , Doenças do Desenvolvimento Ósseo/genética , Osso e Ossos/anormalidades , Anormalidades Craniofaciais/genética , Fatores de Transcrição NFI/genética , Displasia Septo-Óptica/genética , Anormalidades Múltiplas/patologia , Adulto , Doenças do Desenvolvimento Ósseo/patologia , Anormalidades Craniofaciais/patologia , Feminino , Humanos , Recém-Nascido , Mutação , Displasia Septo-Óptica/patologiaRESUMO
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.