Normal values for heart rate variability parameters in children 6–8 years of age: the <scp>PANIC</scp> Study

Seppälä, Santeri; Laitinen, Tomi; Tarvainen, Mika P.; Tompuri, Tuomo; Veijalainen, Aapo; Savonen, Kai; Lakka, Timo A.

doi:10.1111/cpf.12096

Cited by 60 publications

(52 citation statements)

References 31 publications

(53 reference statements)

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“…When comparing pre and post-surgical values between boys and girls, no significant differences were found in the same HRV parameters, which is consistent with previous studies that stated no differences in children HRV values according to gender [1,30].…”

Section: Discussionsupporting

confidence: 91%

“…Diminished HRV occurs when there's both autonomic inactivity and excessive sympathetic inputs [2], showing an ANS imbalance that may be induced by increased stress or autonomic neuropathy [30]. Time domain parameters (SDNN, RMSSD and pNN50) strongly reflect parasympathetic modulation of sinus node [4] and, although there´s not a consensus among the scientific community about frequency domain parameters, most authors consider HF component as an expression of vagal activity influenced by respiration and LF component as a reflection of both cardiac sympathetic and parasympathetic activity with predominance of the sympathetic discharge [5].…”

Section: Discussionmentioning

confidence: 99%

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Heart Rate Variability in Children Submitted to Surgery

Silva¹,

Pinheiro²,

Almeida³

2016

J Anesth Clin Res

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Objective: Heart Rate Variability (HRV) is known to reflect the sympathetic/parasympathetic interaction on several physiological and pathological conditions such as the cardiac activity responsiveness to physiological and environmental stimuli. Therefore, it has been widely used to assess nervous autonomic fluctuations and their influence on sinus node. Studies on children have demonstrated the correlation between HRV and different parameters like age, gender, physical activity and autonomic diseases whereas little evidence exists of the effects of surgery and residual anesthesic drugs on HRV. The aim of this study was to define the possible role of minor surgery in HRV in healthy children.Design: Observational prospective cohort study.Setting: Pediatric Surgery Department of a tertiary, university-affiliated hospital.Patients: 47 healthy children who were scheduled for elective minor surgery.Measurements and Main Results: HRV measurements of 10 to 15 minutes were obtained before and after surgery, using a Holter recorder and the BioSigBrowser ® software. Results showed significant differences in HRV time domain indices before and after surgery in younger patients and in frequency domain in the older ones. They also demonstrated decreased HRV indices until one hour after being submitted to surgery in both time domain and LF parameters, reflecting a parasympathetic withdrawal and sympathetic predominance. Differences were also found when analyzing other variables such as anesthetic drugs. Conclusion:This study demonstrated that surgery has impact on Autonomic Nervous System function in healthy children but, independently of anesthetic drugs, type of surgery, age and existence of pain 60 minutes after surgery no difference in HRV measures was found and autonomic homeostasis was re-established. However, further investigation in this area is required in order to a better support of the role of HRV monitoring on early prognosis prediction and risk stratification in the surgical context.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability in Children Submitted to Surgery

Silva¹,

Pinheiro²,

Almeida³

2016

J Anesth Clin Res

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“…It is important to highlight that previous investigations that evaluated the reliability of HRV in children (Winsley et al ., ; Leicht & Allen, ; Dietrich et al ., ; Seppala et al ., ), adults (Pitzalis et al ., ; Kobayashi, ; Pinna et al ., ; Nunan et al ., ) and patients with different diseases (Maestri et al ., ; Sacre et al ., ) have found lower ICC for HRV parameters than those observed in this study. Winsley et al .…”

Section: Discussionmentioning

confidence: 99%

“…obesity, high blood pressure, physical inactivity) (Urbina et al, 1998;Buchheit et al, 2007;Zhou et al, 2012;Farah et al, 2013Farah et al, , 2014Jaiswal et al, 2013). As a consequence, interest in analysing the HRV is growing, in order to provide a better understanding of these parameters as predictors of cardiovascular risk since youth (Srinivasan et al, 2002;Michels et al, 2013;Seppala et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Intra‐individuals and inter‐ and intra‐observer reliability of short‐term heart rate variability in adolescents

Farah

Andrade-Lima

Cavalcante

et al. 2014

Clin Physio Funct Imaging

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“…Similar studies in adult patients have shown no difference in terms of HRV recovery between general and locoregional anesthesia. Likewise, Ireland et al did not find any difference on HRV indices after awakening according to the anesthetic agent used, while Seppälä et al showed that HRV did not vary between boys and girls . HRV could vary with pain levels.…”

Section: Discussionmentioning

confidence: 96%

Autonomic cardiac regulation after general anesthesia in children

Venet

Pichot

Charier

et al. 2018

Pediatric Anesthesia

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Summary Background General anesthesia dramatically decreases the activity of the autonomic nervous system. Most of the hypnotic agents used to induce anesthesia inhibit sympathetic cardiovascular regulation and baroreflex control in a dose‐dependent manner, lowering cardiac adaptability during the operation. The consequence of this effect in children during and after surgery has never been studied to date. Aim The aim of this study was to follow the variations in autonomic cardiac indices in children younger than 8 years old after general anesthesia (6‐24 hours) in programmed surgery. Method A prospective descriptive monocentric study of 44 children under 8 years old who underwent scheduled surgery at our hospital center (Saint‐Étienne University Hospital, France) was performed between June 1, 2016 and November 1, 2016. Heart rate variability was monitored for 24 hours using Holter‐ECG devices and the resulting data were interpreted using linear and nonlinear analyses. Results Compared to baseline thresholds before surgery, all heart rate variability indices decreased dramatically during general anesthesia. After awakening, a slight reduction in sympathetic activity persisted 6 hours after surgery, but all measurements of sympathetic and parasympathetic activity had returned to baseline thresholds 12 hours after the operation. Twenty‐four hours after surgery, some parameters had increased above the corresponding baseline levels. Conclusion Autonomic nervous function normalizes rapidly (within 12 hours) in prepubertal children. This study indicates that general anesthesia does not seem to increase the long‐term risk of autonomic dysfunction in these patients.

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Normal values for heart rate variability parameters in children 6–8 years of age: the PANIC Study

Abstract: Same reference values for HRV parameters can be used in boys and girls. Although 5-min ECG recordings are preferable for measuring HRV, also 1-min recordings provide reliable data on most HRV parameters, especially those that mainly describe cardiac parasympathetic regulation.

Cited by 60 publications

References 31 publications

Heart Rate Variability in Children Submitted to Surgery

Heart Rate Variability in Children Submitted to Surgery

Intra‐individuals and inter‐ and intra‐observer reliability of short‐term heart rate variability in adolescents

Autonomic cardiac regulation after general anesthesia in children

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