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Am J Perinatol. 2014 Nov;31(10):855-62. doi: 10.1055/s-0033-1361937. Epub 2013 Dec 17.

Depressed heart rate variability is associated with abnormal EEG, MRI, and death in neonates with hypoxic ischemic encephalopathy.

Author information

1
Division of Neonatology, Department of Pediatrics, University of Virginia, Charlottesville, Virginia.
2
Division of Neuroradiology, Department of Radiology and Medical Imaging, University of Virginia, Charlottesville, Virginia.
3
Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, Virginia.
4
Division of Cardiovascular Medicine, Department of Medicine, University of Virginia, Charlottesville, Virginia.

Abstract

OBJECTIVE:

Asphyxia can lead to autonomic nervous system dysfunction, including depressed heart rate variability (HRV). We tested the hypothesis that low HRV is associated with adverse short-term outcomes of abnormalities on electroencephalogram (EEG) and brain magnetic resonance imaging (MRI) and death in neonates with hypoxic ischemic encephalopathy (HIE).

STUDY DESIGN:

Neonates undergoing hypothermia therapy for HIE underwent monitoring of HRV. HRV in the first day after birth and after hypothermia and rewarming (days 4-7) were analyzed in relation to death and severity of abnormal findings on EEG and MRI.

RESULTS:

A total of 37 neonates had data available in the first 24 hour after birth and 67 had data days 2 to 7. Depressed HRV was significantly associated with adverse outcomes of death or moderate-to-severe abnormalities on EEG or MRI. In the first 24 hours, the odds ratio (OR) of one or more adverse outcomes for every 10-millisecond decrease in HRV was 3.19 (95% CI, 1.3-7.8; p = 0.01). HRV improved over time but low HRV remained significantly associated with adverse outcomes days 4 to 7 (OR, 2.72; CI, 1.32-5.61; p < 0.01).

CONCLUSIONS:

Monitoring HRV, which is reflected in the heart rate characteristic index, may provide useful adjunct information on the severity of brain injury in infants with HIE.

PMID:
24347263
DOI:
10.1055/s-0033-1361937
[Indexed for MEDLINE]

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