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Heart rate variability in encephalopathic newborns during and after therapeutic hypothermia

Journal of Perinatology volume 34, pages 836–841 (2014)Cite this article

Subjects

Abstract

Objective:

To evaluate whether heart rate variability (HRV) measures are predictive of neurological outcome in babies with hypoxic ischemic encephalopathy (HIE).

Study Design:

This case–control investigation included 20 term encephalopathic newborns treated with systemic hypothermia in a regional neonatal intensive care unit. Electrocardiographic data were collected continuously during hypothermia. Spectral analysis of beat-to-beat heart rate interval was used to quantify HRV. HRV measures were compared between infants with adverse outcome (death or neurodevelopmental impairment at 15 months, n=10) and those with favorable outcome (survivors without impairment, n=10).

Result:

HRV differentiated infants by outcome during hypothermia through post-rewarming, with the best distinction between groups at 24 h and after 80 h of life.

Conclusion:

HRV during hypothermia treatment distinguished HIE babies who subsequently died or had neurodevelopmental impairment from intact survivors. This physiological biomarker may identify infants in need of adjuvant neuroprotective interventions. These findings warrant further investigation in a larger population of infants with HIE.

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Acknowledgements

This project was supported by Award Numbers UL1RR031988 and KL2 RR031987 from the NIH National Center for Research Resources. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health

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Authors and Affiliations

  1. Department of Neonatology, Children's National Medical Center, Washington, DC, USA,

    A N Massaro & N N Andescavage

  2. Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA,

    A N Massaro, R B Govindan, T Al-Shargabi, N N Andescavage, M Metzler & A J du Plessis

  3. Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA,

    A N Massaro, R B Govindan, N N Andescavage, T Chang, P Glass & A J du Plessis

  4. Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA

    T Al-Shargabi

  5. Department of Neurology, Children's National Medical Center, Washington, DC, USA,

    T Chang

  6. Department of Psychiatry and Behavioral Sciences, Children’s National Medical Center, Washington, DC, USA

    P Glass

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  1. A N Massaro
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  2. R B Govindan
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  3. T Al-Shargabi
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Correspondence to A N Massaro.

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Massaro, A., Govindan, R., Al-Shargabi, T. et al. Heart rate variability in encephalopathic newborns during and after therapeutic hypothermia. J Perinatol 34, 836–841 (2014). https://doi.org/10.1038/jp.2014.108

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  • DOI: https://doi.org/10.1038/jp.2014.108

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