Laura Pretorius

Premature infants have a higher risk of developing serious infection, but a new detection method developed by U.Va. physicians may help cut mortality and illness rates.

New monitoring system helps high-risk newborns

By Catherine Seigerman

Medical researchers at the Health System have developed a method that may alert physicians to early stages of severe infection in newborn infants. In this month's edition of the journal Pediatrics, neonatologist Dr. M. Pamela Griffin and cardiologist Dr. J. Randall Moorman describe a new system for detecting subtle abnormalities of the heartbeat that may forewarn doctors about infection before the baby looks sick.

"Infection is a major cause of illness and death in newborn babies, and especially in premature infants," Griffin said. "As many as 25 percent of very premature babies in intensive care units develop serious bloodstream infections, making their death rate twice as high and hospitalizations much longer."

The researchers worked with computer software engineers at Medical Automation Systems in Charlottesville to develop a continuous online monitoring procedure that requires no contact with the infant other than standard skin patches to monitor heart rate.

Griffin and Moorman studied three groups: babies showing signs of illness whose blood tested positive for infection; infants who had similar signs but had blood testing negative for infection; and a control group without signs of illness. The infants were at high risk for infection because of low birthweight, prematurity and more than two weeks' hospitalization.

"We found that abnormal heart rate characteristics preceded visible symptoms by as much as 24 hours," Moorman said. The changes were too subtle to be detected with heart rate monitors currently used in NICUs. "By the time signs and symptoms show and prompt doctors to do blood tests, sepsis can have quickly developed to a severe level."

Since the published work was completed, the researchers have studied 350 infants in NICUs at U.Va. and Wake Forest University School of Medicine in North Carolina, and found that the monitoring strategy developed at U.Va. was also effective at the second hospital.

Griffin and Moorman believe the earlier detection method will cut mortality and illness rates among NICU babies, in addition to saving health care dollars by shortening hospital stays. They will soon begin a multicenter clinical study of their device to monitor heart rate characteristics for purposes of seeking FDA approval.