Investigation of the diagnostic significance of hypothermia and its relationship with sepsis parameters in the diagnosis of neonatal sepsis

INVESTIGATION OF THE DIAGNOSTIC SIGNIFICANCE OF HYPOTHERMIA AND ITS RELATIONSHIP WITH SEPSIS PARAMETERS IN THE DIAGNOSIS OF NEONATAL SEPSIS. Introduction: Sepsis in infants is a rare cause of fever. Infants with severe bacterial infections may not experience an increase in body temperature. Paradoxically, hypothermia is more common in newborns with sepsis. Proven sepsis is patients whose clinical and laboratory findings are compatible with sepsis and the causative agent has been shown. Clinical sepsis is patients in whom clinical and laboratory findings are compatible with sepsis, but the causative agent cannot be demonstrated. In infants, a body temperature between 36.0 and 36.4ºC is defined as mild hypothermia, between 32.0-35.9ºC as moderate hypothermia and below 32ºC as severe hypothermia. While hypothermia in newborns may be caused by sepsis, the effect of environmental factors is also important. In our study, the diagnostic significance of hypothermia in neonatal sepsis and its relationship with clinical and laboratory parameters were investigated. Material methods: Our study was carried out by retrospectively examining the data in the system of 813 patients whose body temperatures were measured from the patients hospitalized between 01/12/2018 and 31/12/2020 in Rize Recep Tayyip Erdoğan University Neonatal Intensive Care Service. Results: While the mean body temperature of 537 patients admitted with diagnoses other than early-onset sepsis was 35.9±0.60C at the time of hospitalization, the mean body temperature of 305 patients hospitalized with the diagnosis of early-onset sepsis was 35.8±0.60C, no difference was detected. Of 383 patients who were transferred from other centers, 63 (16.4%) had normothermia, 183 (47.7%) had mild hypothermia and 137 (35.7%) had moderate hypothermia. Of the 429 patients who came out of transfer, 84 (19.5%) had normothermia, 224 (52.2%) had mild hypothermia, and 121 (28.2%) had moderate hypothermia. Of 589 patients born with C/S, 107 (18.1%) had normothermia, 268 (45.5%) had mild hypothermia, and 214 (36.3%) moderate hypothermia. Of 223 patients born vaginally, 40 (17.8%) had normothermia, 139 (62.0%) had mild hypothermia and 44 (19.6%) had moderate hypothermia. It was observed that the rate of moderate hypothermia in infants born with C/S was significantly higher than those born vaginally. Conclusion: In the examination performed on patients diagnosed with early-onset sepsis and hospitalized with other diagnoses, no significant difference was found about body temperatures. The most common cause of hypothermia is thought to be environmental and preventable factors. For this reason, it is important that every healthcare provider who will take care of the patient from the birth of the patient to neonatal intensive care unit should be informed about maintaining the body temperature of infants, and families should be trained to maintain body temperature. It is important to emphasize that there is a need for further studies on this subject, which is tried to be evaluated by considering the transportation conditions that newborn is exposed to, health conditions before and after hospital transfer, transfer times, qualitative and quantitative out-of-hospital care provided by the professional team during transportation, delivery characteristics, and mode of delivery. Keywords: Early onset sepsis, Hypothermia, Relationship Between Transport Time and Body Temperature