Study of Heart Rate Variability in Sick Newborn Infants

Jenkins, John; Reid, Mark; Mcclure, B. G.

doi:10.1111/j.1651-2227.1980.tb07098.x

Cited by 31 publications

(20 citation statements)

References 9 publications

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“…In studies concerning the influence of RDS on HRV, it has been established that RDS predominantly attenuates LF HRV (2,6,7). This could be confirmed by our study.…”

Section: 208supporting

confidence: 90%

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The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

et al. 1995

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To study the influence of artificial ventilation rate on neonatal heart rate variability (HRV), ECG and respiratory impedance curves were recorded four times a day in 20 preterm infants (<33 wk) during the first 3 d after birth while the infants were ventilated at a wide range of ventilator rates. The contents of selected frequency bands within the R-R interval power spectrum were calculated for 3-min periods. Respiratory distress syndrome severity was assessed at each measurement. Respiratory sinus arrhythmia (RSA) induced by the ventilator appeared to mimic spontaneous RSA. As in spontaneous respiration, the amount of RSA (power in a frequency band around the respiratory rate) increases as the ventilation rate decreases. This phenomenon is most probably due to entrainment with baroreflex-related fluctuations in the heart rate. Although the artificial ventilation rate influences RSA and thus high-frequency HRV, an increase in respiratory distress syndrome severity results in a decrease in low-frequency HRV. Thus, the attenuation of low-frequency HRV by respiratory distress syndrome is not likely to be due to artificial ventilation. (Pediatr Res 37: 124-130, 1995) Abbreviations aRSA, artificial respiratory sinus arrhythmia aVR, artificial ventilation rate HF, high-frequency HRV, heart rate variability LF, low-frequency RDS, respiratory distress syndrome RSA, respiratory sinus arrhythmia VLF, very LF HRV, i.e. the variation in beat-to-beat R-R interval length, is influenced by maturational (e.g. gestational age), physiologic (e.g. respiration), and clinical factors (1, 2). HRV can be assessed by spectral analysis to study the frequency-specific oscillations in the heart rate signal. In the newborn, the following heart rate oscillations may be present. HF oscillations have a frequency equal to the respiratory rate and are known as RSA. LF oscillations are due to intrinsic oscillations of the baroreceptor reflex loop with a frequency of 0.07 Hz (3). A second kind of LF oscillation may result from periodic fluctuations in respiratory depth or tidal volume (4). The last type of HRV features VLF oscillations with a frequency below 0.04 Hz. These are ascribed to thermoregulation. H F oscillations are mediated by the parasympathetic system. LF and VLF oscillations are mediated by both the sympathetic and parasympathetic systems (5). Thus, studying neonatal HRV can give an insight into the maturation of the autonomic nervous system.In newborns suffering from RDS, HRV appears to be atten- HRV returns to normal (2). Several explanations have been proposed for this reversible effect of RDS on HRV. For instance, it has been ascribed to transient depression of the medulla oblongata by hypercarbia (2). The possible influence of artificial ventilation as such on neonatal HRV has not been taken into account in studies regarding the influence of RDS. For the correct interpretation of HRV in infants with RDS, insight into the effect of artificial ventilation on HRV is needed. This influence cannot be studied by simply comparing...

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“…In studies concerning the influence of RDS on HRV, it has been established that RDS predominantly attenuates LF HRV (2,6,7). This could be confirmed by our study.…”

Section: 208supporting

confidence: 90%

“…In newborns suffering from RDS, HRV appears to be attenuated (2,6,7). With improvement of the neonatal condition, HRV returns to normal (2).…”

mentioning

confidence: 97%

The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

et al. 1995

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“…During the first 12h of life, increased heart rate (HR) and decreased heart rate variability (HRV) have been found in infants with PIVH [18]. On the other hand, increased cyclic variations of HR and mean blood pressure (MBP) have also been reported in infants with severe PIVH [7].…”

Section: Introductionmentioning

confidence: 96%

Elevated arterial blood pressure is associated with peri-intraventricular haemorrhage

et al. 1994

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“…The loss of HRV is reported to reflect an alteration in autonomic nervous system function (16)(17)(18). A number of disease states are associated with changes in HRV, including heart failure (19,20), sudden infant death syndrome (21), myocardial infarction (22,23), prematurity (24), neonatal respiratory distress syndrome (25)(26)(27)(28), and diabetes (29). We hypothesize that CCHS patients will exhibit changes in HRV and that these changes have the potential to provide insights into the nature of autonomic control in CCHS.…”

mentioning

confidence: 99%

Heart Rate Variability in Congenital Central Hypoventilation Syndrome

Woo²,

et al. 1992

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ABSTRACT. Heart rate variability was assessed in 12 patients with congenital central hypoventilation syndrome (CCHS) and in age-and sex-matched controls using SD of time intervals between R waves (R-R intervals), R-R interval histograms, spectral analysis, and PoincarC plots of sequential R-R intervals over a 24-h period using ambulatory monitoring. Mean heart rates in patients with CCHS were 103.3 f 17.7 SD and in controls were 98.8 f 21.6 SD ( p > 0.5, NS). SD analysis of R-R intervals showed similar results in both groups (CCHS 102.2 f 36.0 ms versus controls 126.1 f 43.3 ms; p > 0.1, NS). Spectral analysis revealed that, for similar epochs sampled during quiet sleep and wakefulness, the ratios of low-frequency band to high-frequency band spectral power were increased for 11 of 12 patients with CCHS during sleep, whereas a decrease in these ratios was consistently observed in all controls during comparable sleep states (xZ = 20.31; p < 0.000007). During wakefulness, the ratios of low-frequency band to high-frequency band spectral power were similar in both patients with CCHS and controls. Poincare plots displayed significantly reduced beat-to-beat changes at slower heart rates in the CCHS patients (xZ = 24.0; p < 0.000001). The scatter of points in CCHS Poincare plots was easily distinguished from controls. All CCHS patients showed disturbed variability with one or more measures. The changes in moment-to-moment heart rate variability suggest that, in addition to a loss of ventilatory control, CCHS patients exhibit a dysfunction in autonomic nervous system control of the heart. (Pediafr Res 31: 291-296, 1992) Abbreviations CCHS, congenital central hypoventilation syndrome HRV, heart rate variability R-R, time interval between R waves LO-HI, ratio of low-frequency band to high-frequency band spectral power

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Study of Heart Rate Variability in Sick Newborn Infants

Cited by 31 publications

References 9 publications

The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

Elevated arterial blood pressure is associated with peri-intraventricular haemorrhage

Heart Rate Variability in Congenital Central Hypoventilation Syndrome

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