Longitudinal assessment of heart rate variability in very low birth weight infants during their NICU stay

Khattak, Asif Z.; Padhye, Nikhil; Williams, Amber; Lasky, Robert E.; Moya, Fernando; Verklan, M. Terese

doi:10.1016/j.earlhumdev.2006.07.007

Cited by 20 publications

(17 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…HRV measurements in both groups had large SDs, a finding that has also been reported in healthy newborn infants [18]. Nevertheless, large SDs may account for the level of uncertainty in outcome prediction.…”

Section: Discussionsupporting

confidence: 62%

See 1 more Smart Citation

Heart Rate Variability and Extubation Readiness in Extremely Preterm Infants

et al. 2013

View full text Add to dashboard Cite

Background: Mechanical ventilation (MV) is associated with changes in autonomic nervous system activity in preterm infants, which can be assessed by measurements of heart rate variability (HRV). Decreased HRV has been described in adults undergoing disconnection from MV; such information is not available in preterm infants. Objective: To compare differences in HRV between infants successfully extubated and those who failed, and to evaluate the accuracy of HRV as a predictor of extubation readiness. Methods: This is a prospective, observational study of infants with a birth weight ≤1,250 g undergoing their first extubation attempt. Heart rate was measured during a 60-min period immediately prior to extubation and HRV was calculated using the frequency domain analysis. Results: A total of 47 infants were studied; 36 were successfully extubated and 11 reintubated. There were no differences in patient demographics, ventilator settings, blood gases or postextubation management between the groups. All components of the HRV analysis were significantly decreased in infants who failed, generating high areas under the receiver operating characteristic curve. The specificity and positive predictive values were 100, but with limited sensitivity and negative predictive values. Conclusions: Infants considered ‘ready to be extubated' but who subsequently failed their first extubation attempt had decreased HRV prior to extubation. Though promising, the value of HRV as a predictor of extubation readiness requires further evaluation.

show abstract

Section: Discussionsupporting

confidence: 62%

“…Overall, preterm infants have a lower HRV when compared to term newborns [18]. HRV may also be influenced by position, postnatal age, and sleep stage [19,20].…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability and Extubation Readiness in Extremely Preterm Infants

et al. 2013

View full text Add to dashboard Cite

show abstract

“…Critically ill preterm newborns have depressed HRV at normal body temperature [15] . Increased LF and HF HRV power during cooling in term newborns replicate the results in adult hypothermia-treated patients [16] .…”

Section: Discussionmentioning

confidence: 99%

Changes in the PQRST Intervals and Heart Rate Variability Associated with Rewarming in Two Newborns Undergoing Hypothermia Therapy

et al. 2009

Self Cite

View full text Add to dashboard Cite

Background: Little is known about the effects of hypothermia therapy and subsequent rewarming on the PQRST intervals and heart rate variability (HRV) in term newborns with hypoxic-ischemic encephalopathy (HIE). Objectives: This study describes the changes in the PQRST intervals and HRV during rewarming to normal core body temperature of 2 newborns with HIE after hypothermia therapy. Methods: Within 6 h after birth, 2 newborns with HIE were cooled to a core body temperature of 33.5°C for 72 h using a cooling blanket, followed by gradual rewarming (0.5°C per hour) until the body temperature reached 36.5°C. Custom instrumentation recorded the electrocardiogram from the leads used for clinical monitoring of vital signs. Generalized linear mixed models were calculated to estimate temperature-related changes in PQRST intervals and HRV. Results: For every 1°C increase in body temperature, the heart rate increased by 9.2 bpm (95% CI 6.8–11.6), the QTc interval decreased by 21.6 ms (95% CI 17.3–25.9), and low and high frequency HRV decreased by 0.480 dB (95% CI 0.052–0.907) and 0.938 dB (95% CI 0.460–1.416), respectively. Conclusions: Hypothermia-induced changes in the electrocardiogram should be monitored carefully in future studies.

show abstract

“…However, when the same subjects were re-investigated at 2-3 and 6-7 y, no significant difference in HRV parameters persisted in comparison with the controls (16). The impairment in ANS function among the group of premature infants was suggested to be an effect of stress owing to pain, noise, visual stimuli, inadequate nutrition, and ventilator support (17)(18)(19). It is known that the sympathetic nervous system matures earlier in fetal life than the parasympathetic nervous system but then becomes increasingly outbalanced beyond 30 wk of gestational age, which could explain a temporary dominance of the sympathetic system at the beginning of life for children born PT (19,20).…”

Section: Articlesmentioning

confidence: 97%