Families and the Sepsis Work-up: Considering their Fears

Abstract

The neonatal patient is at significant risk for sepsis sometime during initial hospitalization in the Neonatal Intensive Care Unit (NICU). These risks include: an immature immune system; a skin barrier that is fragile and/or often penetrated to obtain needed lab testing or intravenous access; and poor nutritional status. Neonatal patients routinely require central venous access to provide long term nutrition and delivery of medications. Invasive lines as well as other foreign bodies like endotracheal tubes increase the incidence of sepsis in this population. 1 According to Kugelman, et al (2008) 2 the incidence of iatrogenic infections of the neonate during hospitalization is 18.2%. There is a significant inverse relationship between gestational age, birth weight and infection rates. That is with decreasing gestational ages and birth weights, preterm infants are at increased risk for development of infection. Infants who weigh less than 1000 grams and are 24 to 27 weeks gestation have an expected infection rate of 57% before hospital discharge. 3 Thus, sepsis is an issue of concern to both health