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Heart rate variability in hypoxic ischemic encephalopathy during therapeutic hypothermia
Robert M Goulding1,2, Nathan J Stevenson1, Deirdre M Murray1,2
1INFANT Centre, Neonatal Brain Research Group, University College Cork, Cork, Ireland.
Pediatric Research
|November 18, 2016
Summary
Therapeutic hypothermia (TH) improves heart rate variability (HRV) in infants with moderate hypoxic ischemic encephalopathy (HIE). The high-frequency (HF) component of HRV increased in infants undergoing TH, indicating potential neuroprotective effects.
Area of Science:
- Neonatal Neurology
- Cardiology
- Pediatric Critical Care
Background:
- Hypoxic ischemic encephalopathy (HIE) is a serious condition in newborns.
- Therapeutic hypothermia (TH) is used to mitigate brain injury in HIE.
- Heart rate variability (HRV) reflects autonomic nervous system function and can indicate injury severity.
Purpose of the Study:
- To evaluate the impact of TH on HRV in infants with HIE.
- To compare HRV parameters between infants before and after TH implementation.
- To correlate HRV features with HIE severity.
Main Methods:
- Assessed multichannel video-electroencephalography (EEG) and electrocardiography in term infants with HIE.
- Compared HRV features (mean NN, SDNN, TINN, HF, LF, VLF, LF/HF ratio) between pre-TH and TH groups.
- Utilized linear mixed model comparisons to analyze HRV data.
Main Results:
- 118 infants were analyzed (44 pre-TH, 74 TH).
- Most HRV features decreased with increasing HIE severity (EEG grade).
- Infants with moderate HIE receiving TH showed significantly altered HRV (increased HF, decreased LF/HF ratio) compared to the pre-TH group.
Conclusions:
- The high-frequency (HF) component of HRV is significantly increased in moderate HIE infants undergoing TH.
- TH appears to modulate autonomic nervous system function in HIE infants.
- HRV analysis may serve as a biomarker for HIE severity and response to TH.
