Does heart rate variability improve prediction of failed extubation in preterm infants?
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Marciali Gonçalves Fonseca Silva
Abstract
Background
Prematurity and its respective comorbidities may result in longer periods of mechanical ventilation in intensive care units (ICU). A method for the assessment of organic maturity would be useful for this population. Heart rate variability (HRV), as an indicator of homeostasis, is a well-established tool for this approach. The objective of the study was to assess HRV in intubated preterm infants in ICU immediately prior to extubation and correlate HRV with clinical evaluation outcomes.
Methods
A total of 46 preterm infants, 13 (28.2%) males, were prospectively studied and divided into a group with failed extubation (FEG: n=11) and a group with successful extubation (SEG: n=35). HRV was evaluated in time, frequency and nonlinear domains with a Polar RS800 device. HRV measurements were assessed with Kubios HRV Premium Software and statistically analyzed with the StatsDirect Statistical Software, version 1.9.2015 (2002). P<0.05 values were considered as statistically significant.
Results
There were no significant differences between heart rate variables of failed and successful extubation when analyzing the total group. However, the analysis of the sub-group of preterm infants weighing less than 1000 g showed a clear differentiation between the groups, when the nonlinear variables (approximate entropy, sample entropy and multiscale entropy 1, 2 and 3) were used, demonstrating that the group with successful extubation shows greater complexity and, therefore, relatively greater autonomic stability.
Conclusion
HRV was effective in predicting failed extubation in preterm infants when evaluated in a nonlinear domain and in preterm infants weighing less than 1000 g.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
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©2019 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- Ultrasound Doppler waveform assessment: the story continues
- Review
- Association between increased antenatal vaginal pH and preterm birth rate: a systematic review
- Mini Review
- Update on uterine tachysystole
- Research Articles – Obstetrics
- First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study
- Emergency peripartal hysterectomy – a single-center analysis of the last 13 years at a tertiary perinatal care unit
- Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor
- Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population
- Effect of dual tocolysis with fenoterol and atosiban in human myometrium
- Antecedents of red cell transfusion in a large contemporary obstetric cohort
- Effect of n-3 long-chain polyunsaturated fatty acids supplementation in healthy mothers on DHA and EPA profiles in maternal and umbilical blood: a randomized controlled trial
- Research Articles – Fetus
- Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy
- Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction
- Doppler evaluation of the fetal pulmonary artery pressure
- Mechanisms of death in structurally normal stillbirths
- The diagnostic value of a detailed first trimester anomaly scan in fetuses with increased nuchal translucency thickness
- Research Articles – Newborn
- Small for gestational age and extremely low birth weight infant outcomes
- Does heart rate variability improve prediction of failed extubation in preterm infants?
Artikel in diesem Heft
- Frontmatter
- Editorial
- Ultrasound Doppler waveform assessment: the story continues
- Review
- Association between increased antenatal vaginal pH and preterm birth rate: a systematic review
- Mini Review
- Update on uterine tachysystole
- Research Articles – Obstetrics
- First trimester prediction of gestational diabetes mellitus using plasma biomarkers: a case-control study
- Emergency peripartal hysterectomy – a single-center analysis of the last 13 years at a tertiary perinatal care unit
- Efficacy and safety of misoprostol vaginal insert vs. oral misoprostol for induction of labor
- Vitamin A and β-carotene in pregnant and breastfeeding post-bariatric women in an urban population
- Effect of dual tocolysis with fenoterol and atosiban in human myometrium
- Antecedents of red cell transfusion in a large contemporary obstetric cohort
- Effect of n-3 long-chain polyunsaturated fatty acids supplementation in healthy mothers on DHA and EPA profiles in maternal and umbilical blood: a randomized controlled trial
- Research Articles – Fetus
- Effect of psychotropic drugs on fetal behavior in the third trimester of pregnancy
- Prognostic value of the aortic isthmus Doppler assessment on late onset fetal growth restriction
- Doppler evaluation of the fetal pulmonary artery pressure
- Mechanisms of death in structurally normal stillbirths
- The diagnostic value of a detailed first trimester anomaly scan in fetuses with increased nuchal translucency thickness
- Research Articles – Newborn
- Small for gestational age and extremely low birth weight infant outcomes
- Does heart rate variability improve prediction of failed extubation in preterm infants?
