Key result
Depressed HRV precedes clinical necrotizing enterocolitis diagnosis by 2 days and correlates with disease severity.
Why the study?
There are no reliable biomarkers to identify premature infants at risk for developing necrotizing enterocolitis (NEC).
Does heart rate variability monitoring detect autonomic depression preceding necrotizing enterocolitis in premature infants?
Observational (n=30)
Does heart rate variability monitoring detect autonomic depression preceding necrotizing enterocolitis in premature infants?
Effect estimate: AUC < 0.7
Heart rate variability monitoring may detect autonomic depression preceding the clinical diagnosis of necrotizing enterocolitis in premature infants, potentially serving as an early biomarker.
May signal impending NEC but limited predictive value precludes practice change; hypothesis-generating and requires prospective validation.
BACKGROUND: Necrotizing enterocolitis (NEC) is a complication of prematurity with a high mortality rate. Currently, there are no reliable biomarkers capable of identifying infants at risk for developing NEC. We sought to determine the autonomic nervous system antecedents of NEC in premature infants, using heart rate variability (HRV). MATERIALS AND METHODS: HRV was quantified by retrieving archived electrocardiogram (EKG) data from 30 premature infants from 4 days prior, through 4 days after, the clinical NEC diagnosis. HRV metrics were compared with those on the diagnosis day using the receiver operating characteristic (ROC) analysis. RESULTS: HRV metrics showed a depression of autonomic tone that preceded the clinical NEC diagnosis by 2 days, and which recovered to baseline by 2 days after diagnosis (area under the curve [AUC] < 0.7). The pattern of HRV change was significantly associated with the clinical severity of NEC (stage II vs. stage III). CONCLUSION: Our studies suggest that readily accessible metrics of autonomic depression might expedite the diagnosis of NEC and its severity in a clinically meaningful manner. Clearly, these studies need to be extended prospectively to determine the diagnostic utility of this approach.
No takes yet. Share an insight, caveat, or question.
Al‐Shargabi et al. (2018) conducted an observational in Necrotizing enterocolitis (n=30). Heart rate variability (HRV) metrics vs. Diagnosis day was evaluated on Changes in HRV metrics compared to diagnosis day (AUC < 0.7). Heart rate variability metrics demonstrated a depression of autonomic tone preceding clinical necrotizing enterocolitis diagnosis by 2 days (AUC < 0.7), which correlated with disease severity.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: