From the Guidelines
The newborn does not meet SIRS (Systemic Inflammatory Response Syndrome) criteria based on the provided vital signs. The SIRS criteria, as defined by the most recent and highest quality study 1, include a temperature of >38 °C or <36 °C, heart rate of >90 beats per minute, respiratory rate of >20 breaths per minute, and abnormal white blood cell count. In this case, the heart rate of 93 beats per minute is slightly above the normal range for adults but is actually below the normal range for newborns (which is typically 120-160 beats per minute) 1. The respiratory rate of 45 breaths per minute is within normal limits for a newborn (normal range 40-60) 1. While the temperature of 96.6°F (35.9°C) is slightly low, it alone doesn't fulfill SIRS criteria, as the criteria specify a temperature of <36 °C or >38 °C 1. The oxygen saturation of 91% on room air is concerning and warrants attention as healthy newborns typically maintain saturations above 95% 1, but low oxygen saturation alone is not part of the SIRS definition. Key points to consider in the evaluation of this newborn include:
- The low heart rate, which may indicate potential concerns that should be evaluated further
- The borderline low temperature, which may also indicate potential concerns that should be evaluated further
- The oxygen saturation, which is below the normal range for healthy newborns and should be monitored closely. Overall, the newborn's vital signs suggest potential concerns that should be evaluated, but they do not meet the established criteria for SIRS.
From the Research
SIRS Criteria
To determine if a newborn meets the Systemic Inflammatory Response Syndrome (SIRS) criteria, we need to evaluate the provided vital signs:
- Heart Rate (HR): 93
- Temperature: 96.6°F (temporal)
- Respiratory Rate (RR): 45
- Oxygen Saturation (O2): 91% on room air
Evaluation of SIRS Criteria
The SIRS criteria include two or more of the following conditions:
- Body temperature less than 36°C or greater than 38°C
- Heart rate greater than 90 beats per minute for infants
- Respiratory rate greater than 60 breaths per minute for infants or PaCO2 less than 35 mmHg
- White blood cell count (WBC) either greater than 15,000 cells/mm^3 or less than 6,000 cells/mm^3, or greater than 10% bands 2, 3, 4
Application to Newborn
Given the newborn's vital signs:
- The heart rate of 93 meets the SIRS criterion for heart rate.
- The temperature of 96.6°F is within normal limits and does not meet the SIRS criterion for temperature.
- The respiratory rate of 45 does not meet the SIRS criterion for respiratory rate, as it is not greater than 60 breaths per minute.
- There is no information provided about the white blood cell count.
Conclusion Based on Provided Information
Based on the information provided and the SIRS criteria, the newborn meets only one of the SIRS criteria (heart rate greater than 90 beats per minute). However, to fully meet the SIRS criteria, two or more conditions must be present. Therefore, based on the provided vital signs alone, the newborn does not meet the SIRS criteria as defined in the studies 2, 3, 4, 5, 6.