114 Comparison of capillary reactivity by white light spectroscopy with laboratory markers in nosocomial neonatal sepsis

Background Early recognition of sepsis is important. Treatment is stopped after a defined time or after laboratory markers have normalized. Repetitive blood sampling is necessary. A noninvasive tool for recognizing septic infants would be helpful. AIM: To determine whether capillary reactivity measured by the non-invasive spectroscopic device Mediscan 2000 (MBR Technics, GER) correlates with laboratory markers in nosocomial sepsis. Methods Infants with positive blood cultures on antibiotics had bloods taken for monitoring. Spectroscopical measurement of capillary refill time (CRT) by Mediscan was performed within 2h of blood sampling. The device measures total haemoglobin in capillaries using a probe with a short pathlength. The probe was placed at the inner forearm and a baseline total haemoglobin value obtained. Then a defined pressure stimulation of 5s at 5N was applied and the reaction recorded. The time between the end of the pressure stimulation and the resulting peak of the capillary refill activity was calculated. White cell, granulocyte and platelet counts and CRP were compared with Mediscan results. Statistical analysis with EXCEL and SPSS. Positive vote from the ethics committee. Results 11 patients (GA 28 weeks, range 25–42, birthweight 1kg, range 0.63–4.23) positive for coagulase-negative staphylococcus in the blood culture were investigated. CRT was 6s (range 2–26s). Leucocyte, granulocyte and platelet count were 20 (range 7.5–32.3), 13 (range 4.6–28.1) and 271 (range 38–554) x109/l respectively. CRP was 19mg/l (range 5–72). There was a significant correlation between the length of the CRT and the number of white cells and granulocytes (r=0.7, p=0.009 and r=0.6, p=0.02). There was no statistical correlation between platelet count or CRP and CRT by Mediscan (p=0.26 and p=0.44). Conclusions Capillary reactivity measured by the Mediscan reflects the condition of the septic infant. It indicates disease severity. Future studies will assess its role in guiding antibiotic treatment and reducing blood samples.