Infection Clinical Trial
Official title:
Comparison of Peripheral Perfusion Level Between Two Groups of Newborns According to Their Infectious Status Defined by the Criteria of the Center for Disease Control and Prevention (CDC)
Despite advances in medicine, secondary neonatal infection remains a continuing concern
because of the associated high morbidity and mortality. The usual mechanism of infection
responds to the transmission of germs by the equipment used for care (eg, catheters) and by
the hands of caregivers. In preterm infants in particular, some infections can also have an
endogenous source, by translocation of colonization germs present in the digestive tract.
The first line of prevention of secondary infection corresponds to compliance with the rules
of hand hygiene, work surfaces and equipment carried out, the effect of which on the control
of the incidence of secondary infection is regularly demonstrated. When declared, bacterial
infection should be treated as quickly as possible with appropriate and effective
antibiotics to preserve the healing prognosis. Compared to the infant and the larger child,
clinical signs of calling are atypical and discrete. In the absence of staff trained to
monitor newborns specifically, there is a real risk of discovering the existence of the
infection only at an advanced stage corresponding, among other things, to circulatory
collapse. This risk is not completely excluded, even with experienced practitioners, because
the positive signs are rude and may go unnoticed (eg, signs of calling such as fever are
rare in the newborn). Support for early diagnosis of neonatal infection by automatic
monitoring systems has reduced mortality by 30% in the units where it has been applied. This
is probably due to the fact that early warning made it possible to start the antibiotic
treatment earlier and to complete the bacteriological diagnosis in order to better orient
the therapeutic attitude. The best criteria for early diagnosis by automated systems were
provided by the statistical analysis of cardiac variability, the results of the research and
correspond to the standard deviation, the asymmetry and the entropy of the series d Cardiac
intervals. Since microbial aggression has an impact on many vegetative variables outside of
the electrocardiogram, our current research aims to determine whether the analysis of the
perfusion index (PI) Which are of interest for detecting disturbances in the early stages of
infection in newborns. IP corresponds to the ratio of the amplitude of the oscillating phase
to the intensity of the constant part of the opto-plethysmography wave; It is obtained from
signals recorded in a non-invasive manner by the same infrared sensor for pulse oximetry.
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