Background
Main body
Conventional management (CM)
The neonatal sepsis calculator (NSC)
Clinical Exam | Description |
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Clinical Illness | 1. Persistent need for NCPAP / HFNC / mechanical ventilation (outside of the delivery room) 2. Hemodynamic instability requiring vasoactive drugs 3. Neonatal encephalopathy /Perinatal depression ▪ Seizure ▪ Apgar Score at 5 min < 5 4. Need for supplemental O2 > 2 h to maintain oxygen saturations > 90% (outside of the delivery room) |
Equivocal | 1. Persistent physiologic abnormality > 4 h ▪ Tachycardia (HR > 160) ▪ Tachypnea (RR > 60) ▪ Temperature instability (> 100.4 °F or < 97.5 °F) ▪ Respiratory distress (grunting, flaring, or retracting) not requiring supplemental O2 2. Two or more physiologic abnormalities lasting for > 2 h ▪ Tachycardia (HR > 160) ▪ Tachypnea (RR > 60) ▪ Temperature instability (> 100.4 °F or < 97.5 °F) ▪ Respiratory distress (grunting, flaring, or retracting) not requiring supplemental O2 Note: abnormality can be intermittent |
Well Appearing | No persistent physiologic abnormalities |
Comparisons between NSC and CM
Serial clinical observation (SCO)
Minor ‡ | Major |
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Mild respiratory distress (> 60 bpm) without the need of respiratory support | Moderate to severe respiratory distress (requiring respiratory support) § → tachypnoea plus increased respiratory effort |
Tachycardia > 160 bpm | Hypoxia, reduced SpO2 saturation |
Metabolic acidosis (base excess ≤ − 10 mmol/lt) | Reduced skin perfusion, Refill time ≥ 3 “ Signs of shock |
Temperature < 36° or > 37.5 < 38 °C | Temperature ≥ 38 °C |
Greyish, pallor or marbling of the skin colour | |
Worsening of general wellbeing, apnoea, lethargy, irritability, convulsions |