Clinical signs that are too aspecific to be useful in exclud- ing or diagnosing LOS were temperature instability, apnoea, tachypnoea, tachycardia, dyspnoea, hyper- and hypothermia, feeding difficulties and irritability. Even when two or more of these aspecific signs occur simultaneously, the risk of neither clinical nor proven sepsis is hardly changed (data not shown).
Lack of clinical relevance of body temperature in diag- nosing LOS in preterms might be attributable to the use of incubators in this specific patient population. When changes in body temperature are observed, the environmental tem- perature in the incubator will be manipulated before serious hypo- or hyperthermia can occur. Probably, the need and magnitude of temperature adjustment of the incubator are more valuable items to measure.