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Establishing normative values for short-term heart rate variability indices in healthy infants in the emergency

Supranee Mathiprechakul1,2, Dagang Guo2, Shu-Ling Chong1,2

  • 1Division of Medicine, Department of Emergency Medicine, KK Women's and Children's Hospital, Singapore, Singapore.

Annals of Translational Medicine
|March 21, 2025
PubMed

Insights

This study establishes normative heart rate variability (HRV) ranges for healthy infants up to 90 days old. A clinical calculator was developed to aid in evaluating short-term HRV in emergency settings.

Area of Science:

  • Pediatric Cardiology
  • Neonatal Health
  • Biomedical Signal Processing

Background:

  • Heart rate variability (HRV) is a recognized indicator of cardiovascular health and mortality risk in various age groups.
  • Short-term (5-minute) HRV is being explored for identifying serious bacterial infections in infants under 90 days.
  • Normative data for short-term HRV indices in this specific infant population is currently lacking.

Purpose of the Study:

  • To evaluate short-term HRV indices in awake, healthy infants older than 48 hours and up to 90 days.
  • To establish a reference range for these HRV indices.
  • To develop a clinical calculator for evaluating short-term HRV in young infants in the emergency department (ED).

Main Methods:

  • A prospective observational study was conducted.
  • Short-term HRV analysis was performed on awake, well infants up to 90 days old in the ED.
  • 108 infants with complete data were included in the analysis.

Main Results:

  • Heart rate (HR) was found to be correlated with HRV, necessitating normalization of HRV parameters.
  • Normative reference ranges for time-domain, frequency-domain, and non-linear HRV metrics were provided.
  • The study cohort included 108 infants (51.9% male) with a median age of 9 days.

Conclusions:

  • Normative values for short-term HRV were established for healthy infants up to 90 days old.
  • A clinical HRV calculator was developed for use in the ED setting.
  • These findings and the calculator can support future clinical validation and research in neonatal populations.
Abstract

Keywords:
Heart rate variability (HRV)emergency department (ED)paediatricsrisk stratification

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