REACTIVE HYPEREMIA OF SKIN MICROCIRCULATION IN SEPTIC NEONATES

Reactive hyperemia after 1 min of arterial occlusion was studied in ba ck, thigh and heel skin of 40 preterm and full-term neonates using las er Doppler flowmetry. Twelve infants had clinical signs of septicemia, but normal laboratory tests at the time of fluxmetry. However, CRP, l eukocyte count and the ratio of immature to total neutrophils increase d during the following days and septicemia was confirmed by positive b lood cultures (septic group). Seven neonates with clinical signs of se pticemia had developed neither positive blood cultures nor laboratory signs (non-septic group). Fifteen were healthy neonates. In the septic neonates, time to reach maximal hyperemia, maximum post-occlusive hyp eremia and recovery time of skin perfusion were increased significantl y in back and thigh skin and the heal skin temperature was decreased w hen compared to healthy neonates. Healthy and non-septic neonates show ed no significant difference in any of the parameters. We conclude tha t altered reactive hyperemia in the skin may be an earlier sign of neo natal septicemia than laboratory tests.