Abnormal Heart Rate Characteristics Predict Urinary Tract Infections in VLBW Infants

Background: Urinary tract infection (UTI) is a common diagnosis in the neonatal intensive care unit (NICU). Approach to diagnosis and management of UTI is controversial in this population, but early detection may lead to improved outcomes. Abnormal heart rate characteristics (HRC) of decreased variability and repetitive transient decelerations are associated with late-onset neonatal sepsis. In an 8-center randomized clinical trial (RCT) of 3,003 VLBW infants, continuous HRC index (HeRO score) monitoring was associated with 22% lower all-cause mortality (Moorman, 2011) and 40% lower septicemia-associated mortality (Fairchild 2013). Urine culture results have …