Predictive monitoring for sepsis and necrotizing enterocolitis to prevent shock

Sullivan, Brynne A.; Fairchild, Karen D.

doi:10.1016/j.siny.2015.03.006

Cited by 67 publications

(58 citation statements)

References 54 publications

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“…Bedside HRV monitoring is available and has been used for other purposes in neonates, such as monitoring of neonatal sepsis 34 and necrotizing enterocolitis. 35 If HRV is found to be a useful measure for evaluating stress during feeding in future research, the use of bedside HRV monitoring during feeding may be worth exploring. Bedside HRV monitoring also has the potential for being useful for measuring autonomic nervous system response in infants in the neonatal intensive care unit related to other stressors (e.g., procedural pain) and interventions intended to reduce stress (e.g., skin-to-skin care).…”

Section: Discussionmentioning

confidence: 99%

Heart Rate Variability as a Feeding Intervention Outcome Measure in the Preterm Infant

Pados¹,

Thoyre²,

Knafl³

et al. 2017

Advances in Neonatal Care

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Background Feeding interventions for preterm infants aim to reduce the physiologic stress of feeding to promote growth. Heart rate variability (HRV) is a potential non-invasive measure of physiologic stress that may be useful for evaluating efficacy of feeding interventions. Purpose To evaluate whether HRV is a sensitive measure of physiologic stress compared to standard physiologic outcomes in the context of a feeding intervention study. Methods This was secondary analysis of a within-subjects, cross-over design study comparing usual care feeding to a gentle, co-regulated feeding approach (CoReg) in 14 infants born < 35 weeks post-menstrual age. HRV indices were calculated from electrocardiogram data and compared to standard physiologic outcomes, including oxygen saturation (SpO2), respiratory rate (RR), apnea, heart rate (HR), and bradycardia. Data were analyzed using linear mixed modeling. Results Infants fed using the CoReg approach had fewer apneic events and higher RR, suggesting they were able to breathe more during feeding. No statistically significant differences were found in SpO2, HR, bradycardia, or high frequency power (the most commonly-reported measure of HRV). Infants fed using the usual care approach had significantly higher SD12, a measure of HRV indicating randomness in the HR, which is a potential indicator of elevated stress. Implications for Practice SD12 was more sensitive to stress than SpO2, HR, and bradycardia. The utility of HRV as a measure of feeding outcomes in clinical practice needs further exploration. Implications for Research Further exploration of HRV as an intervention outcome measure is needed, particularly evaluating non-linear indices, such as SD12.

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Section: Discussionmentioning

confidence: 99%

Heart Rate Variability as a Feeding Intervention Outcome Measure in the Preterm Infant

Pados¹,

Thoyre²,

Knafl³

et al. 2017

Advances in Neonatal Care

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show abstract

“…Some neonatal units are now incorporating sophisticated analysis algorithms into their bedside monitoring, and ultimately these may provide just such a prediction tool. Abnormal heart rate characteristics have been suggested as a useful clinical tool to predict sepsis [25], and have shown initial promise to predict NEC before clinical diagnosis in a prospective trial setting [26]. However, a more recent study in which the same system was used in routine clinical practice suggested that abnormal heart rate characteristics have limited ability to detect sepsis [27].…”

Section: Improved Diagnostic Methodsmentioning

confidence: 99%

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

2017

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Despite decades of research on necrotizing enterocolitis, we still do not fully understand the pathogenesis of the disease, or how to prevent or how to treat it. However, as a result of recent significant advances in the microbiology, molecular biology, and cell biology of the intestine of preterm infants and infants with necrotizing enterocolitis, there is some hope that research into this devastating disease will yield some important translation into effective prevention, more rapid diagnosis, and novel therapies.

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“…With this has come the recognition that analyzing and integrating these datasets can expand the range of questions that can be answered 1 . For example, early results suggest integrating continuous data streams generated by various monitoring systems with clinical outcomes data may enable better prediction and treatment of adverse events in intensive care settings 1,7 . Second, along with this increase in availability of data, there has been a simultaneous decrease in funding to support biomedical research 8 .…”

Section: Data In Medicinementioning

confidence: 99%

Report of the National Heart, Lung, and Blood Institute Working Group

et al. 2016

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The National Heart, Lung, and Blood Institute convened a Working Group in January 2015 to explore issues related to an integrated data network for congenital heart disease (CHD) research. The overall goal was to develop a common vision for how the rapidly increasing volumes of data captured across numerous sources can be managed, integrated, and analyzed to improve care and outcomes. This report summarizes the current landscape of CHD data, data integration methodologies used across other fields, key considerations for data integration models in CHD, and the short- and long-term vision and recommendations made by the Working Group.

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Predictive monitoring for sepsis and necrotizing enterocolitis to prevent shock

Cited by 67 publications

References 54 publications

Heart Rate Variability as a Feeding Intervention Outcome Measure in the Preterm Infant

Heart Rate Variability as a Feeding Intervention Outcome Measure in the Preterm Infant

Current Research on the Epidemiology, Pathogenesis, and Management of Necrotizing Enterocolitis

Report of the National Heart, Lung, and Blood Institute Working Group

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