Sadeq et al identified fluctuations in vital signs that can help to identify a pediatric burn patient with Gram-negative sepsis. The authors are from Shriners Hospitals for Children Boston, Massachusetts General Hospital, Harvard Medical School and Icahn School of Medicine.
Patient selection: pediatric burn patient
Predictors:
(1) number of fever spikes above 39°C >=2
(2) number of heart rate spikes >= 14
(3) number of mean arterial pressure (MAP) dips (less than 60 mm Hg) >= 5
where:
• Heart rate spike is a pulse greater than 2 SD above the mean (beyond the ULN for age).
Performance:
• The combination of findings had a sensitivity of 57%, specificity of 33% and 52% accuracy, which is poor.
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