This study in preterm infants was designed to characterize the prognostic potential of several features of heart rate variability (HRV), respiration, and (infant) motion for the predictive monitoring of late-onset sepsis (LOS). In a neonatal intensive care setting, the cardiorespiratory waveforms of infants with blood-culture positive LOS were analyzed to characterize the prognostic potential of 22 features for discriminating control from sepsis-state, using the Naïve Bayes algorithm. Historical data of the subjects acquired from a period sufficiently before the clinical suspicion of LOS was used as control state, whereas data from the 24 h preceding the clinical suspicion of LOS were used as sepsis state (test data). The overall prognostic potential of all features was quantified at three-hourly intervals for the period corresponding to test data by calculating the area under the receiver operating characteristics curve. For the 49 infants studied, features of HRV, respiration, and movement showed characteristic changes in the hours leading up to the clinical suspicion of sepsis, namely, an increased propensity toward pathological heart rate decelerations, increased respiratory instability, and a decrease in spontaneous infant activity, i.e., lethargy. While features characterizing HRV and respiration can be used to probe the state of the autonomic nervous system, those characterizing movement probe the state of the motor system—dysregulation of both reflects an increased likelihood of sepsis. By using readily interpretable features derived from cardiorespiratory monitoring, opportunities for pre-emptively identifying and treating LOS can be developed.

中文翻译：

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使用心率变异性，呼吸特征和心电图得出的婴儿运动估计值预测新生儿败血症

这项针对早产儿的研究旨在表征心率变异性（HRV），呼吸和（婴儿）运动的几种特征对预后性败血症（LOS）的预测监测的预后潜力。在新生儿重症监护环境中，使用朴素贝叶斯算法，分析了血培养阳性LOS的婴儿的心肺波形，以表征22种特征可区分败血症状态的预后潜力。将从临床上怀疑为LOS之前的足够时间的受试者的历史数据用作对照状态，而将来自临床上怀疑为LOS的24 h之前的数据用作败血症状态（测试数据）。通过计算接收器工作特性曲线下的面积，在与测试数据相对应的时间段内，每隔三个小时对所有功能的总体预后潜力进行量化。在研究的49名婴儿中，HRV，呼吸和运动的特征在导致临床怀疑败血症之前的几小时内表现出特征性变化，即对病理性心率减速的倾向增加，呼吸不稳定性增加以及自发性婴儿减少活动，即嗜睡。虽然可以将表征HRV和呼吸的特征用于探测自主神经系统的状态，但是表征运动的特征可以探测运动系统的状态-两者的失调反映出败血症的可能性增加。