title: Heart rate variability during extracorporeal membrane oxygenation and recovery in severe neonatal disease.
abstract: BACKGROUND
  Heart rate variability (HRV) reveals information on the functional state of the autonomic nervous system (ANS) in neonates. During severe illness, heart rate variability is impaired.
  
  
  OBJECTIVE
  This study was initiated to measure the changes in HRV in neonates during extracorporeal membrane oxygenation (ECMO) and recovery from severe respiratory and circulatory failure. Moreover, we compared our data with HRV data of healthy newborns and we investigated the differences in HRV parameters between ECMO-survivors and non-survivors.
  
  
  METHODS
  This study is of an observational character. We performed short-term recordings of heart rate variability in 14 neonates during ECMO and recovery. We computed time- and frequency-domain HRV parameters.
  
  
  RESULTS
  ECMO significantly affects time-domain HRV parameters. Severe neonatal illness causes a significant reduction of all calculated HRV parameters; clinical recovery is accompanied by an increase of HRV. In comparison with normative data of healthy newborns, however, HRV remains impaired. The ECMO-development ratio separated the non-survivors from the survivors during ECMO therapy.
  
  
  CONCLUSIONS
  During severe neonatal illness, HRV is impaired. It remains to be clarified whether the impairment of HRV during severe illness can predict the neurological outcome. The ability of the E/D ratio as an HRV parameter to serve as a predictive tool has to be corroborated in larger group of patients.
authors.affiliation: Children's Hospital, University of Mannheim, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. elke.longing@kikli.ma.uni-heidelberg.de
authors.forename: Elke
authors.initials: E
authors.lastname: Longin
authors.forename: Thomas
authors.initials: T
authors.lastname: Schaible
authors.forename: Suha
authors.initials: S
authors.lastname: Demirakca
authors.forename: Tamara
authors.initials: T
authors.lastname: Lenz
authors.forename: Stephan
authors.initials: S
authors.lastname: König
mesh_terms: D016022:Case-Control Studies; D015199:Extracorporeal Membrane Oxygenation; D005260:Female; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000503:physiopathology* / Q000628:therapy*; D008297:Male