Rectal-skin temperature difference in septicaemic newborn infants

Area of Science:

• Neonatal Medicine
• Pediatric Infectious Diseases
• Thermoregulation Research

Background:

• Neonatal sepsis poses a significant diagnostic challenge.
• Understanding thermoregulatory responses in neonates is crucial for early detection of infections.
• Existing diagnostic methods for neonatal sepsis can be improved with physiological markers.

Purpose of the Study:

• To investigate the thermoregulatory reactions of newborn infants with sepsis.
• To determine if serial temperature measurements, specifically the rectal-sole temperature difference, can aid in the early diagnosis of neonatal sepsis.
• To differentiate between febrile and afebrile sepsis in neonates based on temperature patterns.

Main Methods:

• Simultaneous serial measurements of skin (sole) and rectal temperatures were conducted.
• A cohort of 55 healthy and 26 septicaemic newborn infants was studied prospectively.
• Septicaemic infants were categorized into three groups based on temperature and clinical condition.

Main Results:

• Healthy infants exhibited a mean rectal-sole temperature difference of 2.5°C.
• Febrile septicaemic infants showed a higher mean difference (6.9°C), while afebrile infants in good condition had a difference of 4.7°C.
• Critically ill septicaemic infants with normal temperatures had a significantly lower difference (1.1°C), indicating a loss of thermoregulatory ability.

Conclusions:

• Newborn infants with sepsis generally demonstrate an adequate thermoregulatory response, evidenced by an increased rectal-sole temperature difference (>3.5°C).
• This thermoregulatory response is impaired in critically ill neonates with sepsis.
• A rectal-sole temperature difference exceeding 3.5°C in neonates with normal temperatures warrants suspicion for sepsis and further investigation.