Imperial College London
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DrJethroHerberg

Faculty of Medicine, Department of Infectious Disease

Clinical Reader in Paediatric Infectious Disease
 
 
 
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Contact

 

j.herberg

 
 
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Location

 

231Wright Fleming WingSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Wittmann:2023:10.1007/s00431-023-04884-7,
author = {Wittmann, S and Jorgensen, R and Oostenbrink, R and Moll, H and Herberg, J and Levin, M and Maconochie, I and Nijman, R},
doi = {10.1007/s00431-023-04884-7},
journal = {European Journal of Pediatrics},
pages = {2205--2214},
title = {Heart rate and respiratory rate in predicting risk of serious bacterial infection in febrile children given antipyretics: prospective observational study},
url = {http://dx.doi.org/10.1007/s00431-023-04884-7},
volume = {182},
year = {2023}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Clinical algorithms used in the assessment of febrile children in the Paediatric Emergency Departments are commonly based on threshold values for vital signs, which in children with fever are often outside the normal range. Our aim was to assess the diagnostic value of heart and respiratory rate for serious bacterial infection (SBI) in children after temperature lowering following administration of antipyretics. A prospective cohort of children presenting with fever between June 2014 and March 2015 at the Paediatric Emergency Department of a large teaching hospital in London, UK, was performed. Seven hundred forty children aged 1 month–16 years presenting with a fever and ≥ 1 warning signs of SBI given antipyretics were included. Tachycardia or tachypnoea were defined by different threshold values: (a) APLS threshold values, (b) age-specific and temperature-adjusted centiles charts and (c) relative difference in z-score. SBI was defined by a composite reference standard (cultures from a sterile site, microbiology and virology results, radiological abnormalities, expert panel). Persistent tachypnoea after body temperature lowering was an important predictor of SBI (OR 1.92, 95% CI 1.15, 3.30). This effect was only observed for pneumonia but not other SBIs. Threshold values for tachypnoea > 97th centile at repeat measurement achieved high specificity (0.95 (0.93, 0.96)) and positive likelihood ratios (LR + 3.25 (1.73, 6.11)) and may be useful for ruling in SBI, specifically pneumonia. Persistent tachycardia was not an independent predictor of SBI and had limited value as a diagnostic test.
AU  - Wittmann,S
AU  - Jorgensen,R
AU  - Oostenbrink,R
AU  - Moll,H
AU  - Herberg,J
AU  - Levin,M
AU  - Maconochie,I
AU  - Nijman,R
DO  - 10.1007/s00431-023-04884-7
EP  - 2214
PY  - 2023///
SN  - 0340-6199
SP  - 2205
TI  - Heart rate and respiratory rate in predicting risk of serious bacterial infection in febrile children given antipyretics: prospective observational study
T2  - European Journal of Pediatrics
UR  - http://dx.doi.org/10.1007/s00431-023-04884-7
UR  - https://link.springer.com/article/10.1007/s00431-023-04884-7
UR  - http://hdl.handle.net/10044/1/103199
VL  - 182
ER  -
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