CoolCuddle and Autonomic Regulation in Infants With Hypoxic-Ischaemic Encephalopathy: An Intervention Study.

Area of Science:

• Neonatal Medicine
• Cardiology
• Developmental Pediatrics

Background:

• Hypoxic-ischaemic encephalopathy (HIE) is a serious birth complication requiring therapeutic hypothermia.
• Heart rate variability (HRV) is a key indicator of autonomic nervous system function in infants.
• Parental presence and touch can influence physiological responses in neonates.

Purpose of the Study:

• To evaluate the impact of 'CoolCuddle', a parental cuddling intervention, on HRV during therapeutic hypothermia for HIE.
• To assess how infant severity and parental presence modulate HRV responses during the intervention.

Main Methods:

• Prospective, single-group, interventional study involving infants undergoing therapeutic hypothermia.
• Time-domain HRV was measured before, during, and after parental cuddling sessions.
• Primary outcomes included heart rate, mean RR interval (ANN), and RMSSD, analyzed in relation to infant Apgar scores and aEEG findings.

Main Results:

• Overall, CoolCuddle did not significantly alter HRV. However, infants with lower Apgar scores or abnormal EEG showed reduced HRV parameters during and after cuddling compared to controls.
• Infants with higher Apgar scores or normal EEG exhibited increased HRV parameters post-cuddle.
• Maternal cuddling was associated with higher post-cuddle RMSSD compared to paternal cuddling (p=0.04).

Conclusions:

• CoolCuddle has a minimal overall effect on HRV in infants undergoing therapeutic hypothermia.
• Autonomic responses to cuddling are modulated by the severity of HIE and the specific parent involved.
• These findings suggest a potential for tailored parental involvement to support vulnerable infants during critical care.