Early-onset neonatal sepsis is associated with a high heart rate during automatically selected stationary periods

Aim This study examined the heart rate variability characteristics associated with early-onset neonatal sepsis in a prospective, observational controlled study. Methods Eligible patients were full-term neonates hospitalised with clinical signs that suggested early-onset sepsis and a C-reactive protein of >10 mg/L. Sepsis was considered proven in cases of symptomatic septicaemia, meningitis, pneumonia or enterocolitis. Heart rate variability parameters (n = 16) were assessed from five-, 15- and 30-minute stationary sequences automatically selected from electrocardiographic recordings performed at admission and compared with a control group using the U-test with post hoc Benjamini-Yekutieli correction. Stationary sequences corresponded to the periods with the lowest changes of heart rate variability over time. Results A total of 40 full-term infants were enrolled, including 14 with proven sepsis. The mean duration of the cardiac cycle length was lower in the proven sepsis group than in the control group (n = 11), without other significant changes in heart rate variability parameters. These durations, measured in five-minute stationary periods, were 406 (367–433) ms in proven sepsis group versus 507 (463–522) ms in the control group (p < 0.05). Conclusion Early-onset neonatal sepsis was associated with a high mean heart rate measured during automatically selected stationary periods.