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Published on: January 27, 2023
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Heart Rate Variability as a Prognostic Tool for Gastroschisis Infants in the Neonatal Intensive Critical Unit
Chioma Moneme1, Sherry L Kausch2, Briana M Belmonte3
1Department of Surgery, The University of Virginia, Charlottesville, Virginia.
American Journal of Perinatology
|January 12, 2024
Summary
Infants with gastroschisis, a congenital defect, show decreased heart rate variability (HRV). This heart rate characteristic (HRC) can predict complications in complex gastroschisis cases, impacting recovery time.
Area of Science:
- Neonatalogy
- Pediatric Surgery
- Critical Care Medicine
Background:
- Gastroschisis is a common congenital abdominal wall defect with increasing incidence.
- It leads to extruded abdominal contents and delayed intestinal motility.
- Abnormal heart rate characteristics (HRCs), like reduced variability, are linked to sepsis-induced inflammation in preterm infants.
Purpose of the Study:
- To investigate if infants with gastroschisis exhibit decreased heart rate variability (HRV) post-birth.
- To determine if HRV can serve as a physiomarker for predicting gastroschisis outcomes.
- To explore the association between HRCs and intestinal inflammation in complex gastroschisis.
Main Methods:
- Analysis of heart rate data and clinical variables from infants with gastroschisis (2009-2020).
- Inclusion of 47 infants with available data for the study period.
- Comparison of clinical characteristics between simple and complex gastroschisis subcategories.
Main Results:
- Infants with complex gastroschisis demonstrated reduced HRV after birth.
- Abnormal HRCs were observed early in infants with sepsis and necrotizing enterocolitis.
- Decreased HRV correlated with the development of gastroschisis complications.
Conclusions:
- Reduced HRV is associated with complex gastroschisis.
- Complex gastroschisis cases result in prolonged time to full enteral feeding and total parenteral nutrition.
- Abnormal HRV may indicate increased risk and severity in gastroschisis infants.
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