Heart rate variability

Relationship to IVH in VLBW neonates

Timothy Watkins, Kimberly Horns, Dinesh Haryadi, Roya Sohaey, Paula Woodward, Ross Milley

Research output: Contribution to journalArticle

Abstract

Objective: We hypothesized that analysis of heart rate variability (HRV) in VLBW neonates on the first day of life (DOL #1) could prospectively identify those infants who would subsequently develop severe intraventricular hemorrhage (IVH). Design: We prospectively studied all newborns born in our nursery weighing less than 1500 gr. On the first day of life, between 12 and 24 hours of age, a single 256 second heart rate trace was recorded and a single cranial ultrasound was simultaneously obtained for each infant. A follow-up heart rate recording and cranial ultrasound were obtained at one week of age on each neonate. Exclusion criteria included dopamine infusion > 5 mcg/kg/minute and complex congenital heart disease. No recordings were obtained from neonates exposed to narcotics within the preceding four hour period. Methods: Each heart rate recording consisted of a single continuous 256 second digitally recorded trace. Power spectra of HRV for both low frequency ranges (0.05 - 0.20 Hz) and high frequency ranges (0.20 - 1.0 Hz) were calculated by Fast Fourier Transform. Only neonates who were intubated at the time of the DOL#1 heart rate recording are discussed here. Preliminary Remits; On DOL #1, neonates who were subsequently found at one week of life to have 'severe' IVH (grades 3 and 4, n=4) were found to have less low-frequency HRV than those infants with grades none, one, or two IVH (one tailed t-test, p= 0.033). These two groups were similar with respect to birthweight and FiO2 requirement at the time of study. This result may be generalizable to high frequency power as well (one tailed t-test, p=.07) as the size of our study grows. Three of the four infants with severe IVH at one week of age had no or only low-grade IVH on DOL #1. This suggests that analysis of HRV on DOL #1 may be a more sensitive indicator of subsequent development of severe IVH than a simultaneously performed cranial ultrasound. HRV analysis may be a functional index of autonomic tone and a reflection of CNS integrity with potential to predict poor outcomes in VLBW neonates.

Original languageEnglish (US)
JournalJournal of Investigative Medicine
Volume44
Issue number1
StatePublished - 1996
Externally publishedYes

Fingerprint

Heart Rate
Newborn Infant
Hemorrhage
Ultrasonics
Time and Motion Studies
Nurseries
Narcotics
Fourier Analysis
Weighing
Power spectrum
Fast Fourier transforms
Heart Diseases
Dopamine

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Cite this

Watkins, T., Horns, K., Haryadi, D., Sohaey, R., Woodward, P., & Milley, R. (1996). Heart rate variability: Relationship to IVH in VLBW neonates. Journal of Investigative Medicine, 44(1).

Heart rate variability : Relationship to IVH in VLBW neonates. / Watkins, Timothy; Horns, Kimberly; Haryadi, Dinesh; Sohaey, Roya; Woodward, Paula; Milley, Ross.

In: Journal of Investigative Medicine, Vol. 44, No. 1, 1996.

Research output: Contribution to journalArticle

Watkins, T, Horns, K, Haryadi, D, Sohaey, R, Woodward, P & Milley, R 1996, 'Heart rate variability: Relationship to IVH in VLBW neonates', Journal of Investigative Medicine, vol. 44, no. 1.
Watkins, Timothy ; Horns, Kimberly ; Haryadi, Dinesh ; Sohaey, Roya ; Woodward, Paula ; Milley, Ross. / Heart rate variability : Relationship to IVH in VLBW neonates. In: Journal of Investigative Medicine. 1996 ; Vol. 44, No. 1.
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