Abstract

Neonatal sepsis accounts for significant morbidity and mortality, particularly among premature infants in the Neonatal Intensive Care Unit. Abnormal vital sign patterns serve as physiomarkers of sepsis and provide early warning of illness before overt clinical decompensation. The systemic inflammatory response to pathogens signals the autonomic nervous system, leading to changes in temperature, respiratory rate, heart rate, and blood pressure. In infants with comorbidities of prematurity, vital sign abnormalities often occur in the absence of infection, which confounds sepsis diagnosis. This review will cover the mechanisms of vital sign changes in neonatal sepsis, including the cholinergic anti-inflammatory pathway mediated by the vagus nerve, which is critical to the host response to infectious and inflammatory insults. We will also review the clinical implications of vital sign changes in neonatal sepsis, including their use in early warning scores and systems to direct clinicians to the bedside of infants with physiologic changes that might be due to sepsis.

Impact

• This manuscript summarizes and reviews the relevant literature on the physiological manifestations of neonatal sepsis and how we monitor and analyze these through vital signs and advanced analytics.

中文翻译：

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生命体征作为新生儿败血症的生理标志物

摘要

新生儿败血症是导致发病率和死亡率显着上升的原因，尤其是在新生儿重症监护病房的早产儿中。异常的生命体征模式可作为败血症的生理标志物，并在明显的临床失代偿之前提供疾病的早期预警。对病原体的全身炎症反应向自主神经系统发出信号，导致体温、呼吸频率、心率和血压发生变化。在患有早产合并症的婴儿中，生命体征异常通常在没有感染的情况下发生，这会混淆脓毒症诊断。这篇综述将涵盖新生儿败血症生命体征变化的机制，包括迷走神经介导的胆碱能抗炎通路，这对宿主对感染和炎症的反应至关重要。

影响

• 本手稿总结并回顾了有关新生儿败血症生理表现以及我们如何通过生命体征和高级分析监测和分析这些表现的相关文献。