Abstract
Neonatal sepsis is a critical pathology that particularly affects the neonates in intensive care, especially if they are preterm and low birth weight, with an incidence varying between 1and 40% according to the onset (early or late) of the disease. Prompt diagnostic and therapeutic interventions could reduce the high percentage of mortality that characterises this pathology, especially in the premature and low weight neonates. The HeRO score analyses the heart rate variability and represents the risk of contracting sepsis because of the hospitalization in the neonatal intensive care unit up to 24 h before the clinical signs. However, it has been demonstrated that the HeRO score can produce many false-positive cases, thus leading to the start of unnecessary antibiotic therapy. In this work, the authors propose an optimised artificial neural network model able to diagnose sepsis early based on the HeRO score along with a series of parameters strictly connected to the risk of neonatal sepsis. The proposed methodology shows promising results, outperforming the diagnostic accuracy of the only HeRO score and reducing the number of false positives, thus revealing itself to be a promising tool for supporting the clinicians in the daily clinical practice.
Highlights
Sepsis is usually defined as a clinical syndrome characterised by systemic signs of infection and the concomitant positivity of blood culture to the presence of pathogenic microorganisms
This study focuses on late-onset sepsis (LONS), which is the first cause of death of very low birth weight (VLBW) neonates who survive the first week of life
The HeRO duet was connected to the patient’s monitor when there were full-blown symptoms; even though there was the need for intubation and the decay of the general conditions, the inflammation indexes were negative
Summary
Sepsis is usually defined as a clinical syndrome characterised by systemic signs of infection and the concomitant positivity of blood culture to the presence of pathogenic microorganisms. Sepsis is divided into two main categories: (i) early-onset sepsis (EONS) and (ii) late-onset sepsis (LONS), according to the period of onset, which can be within the first 72 h of life or after, respectively [1]. This pathology affects infants in neonatal intensive care units (NICU), especially if they are preterm and low birth weight, with an incidence in the literature ranging between 1 and 40%, varying according to the onset period. The main problem in dealing with clinically evident sepsis is to suspect the diagnosis as early as possible
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