title: Heart rate variability in encephalopathic newborns during and after therapeutic hypothermia.
abstract: OBJECTIVE
  To evaluate whether heart rate variability (HRV) measures are predictive of neurological outcome in babies with hypoxic ischemic encephalopathy (HIE).
  
  
  METHODS
  This case-control investigation included 20 term encephalopathic newborns treated with systemic hypothermia in a regional neonatal intensive care unit. Electrocardiographic data were collected continuously during hypothermia. Spectral analysis of beat-to-beat heart rate interval was used to quantify HRV. HRV measures were compared between infants with adverse outcome (death or neurodevelopmental impairment at 15 months, n = 10) and those with favorable outcome (survivors without impairment, n = 10).
  
  
  RESULTS
  HRV differentiated infants by outcome during hypothermia through post-rewarming, with the best distinction between groups at 24 h and after 80 h of life.
  
  
  CONCLUSIONS
  HRV during hypothermia treatment distinguished HIE babies who subsequently died or had neurodevelopmental impairment from intact survivors. This physiological biomarker may identify infants in need of adjuvant neuroprotective interventions. These findings warrant further investigation in a larger population of infants with HIE.
authors.affiliation: 1] Department of Neonatology, Children's National Medical Center, Washington, DC, USA [2] Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA [3] Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA.
authors.forename: A N
authors.initials: AN
authors.lastname: Massaro
authors.affiliation: 1] Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA [2] Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA.
authors.forename: R B
authors.initials: RB
authors.lastname: Govindan
authors.affiliation: 1] Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA [2] Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA.
authors.forename: T
authors.initials: T
authors.lastname: Al-Shargabi
authors.affiliation: 1] Department of Neonatology, Children's National Medical Center, Washington, DC, USA [2] Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA [3] Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA.
authors.forename: N N
authors.initials: NN
authors.lastname: Andescavage
authors.affiliation: Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA.
authors.forename: M
authors.initials: M
authors.lastname: Metzler
authors.affiliation: 1] Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA [2] Department of Neurology, Children's National Medical Center, Washington, DC, USA.
authors.forename: T
authors.initials: T
authors.lastname: Chang
authors.affiliation: 1] Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA [2] Department of Psychiatry and Behavioral Sciences, Children's National Medical Center, Washington, DC, USA.
authors.forename: P
authors.initials: P
authors.lastname: Glass
authors.affiliation: 1] Department of Fetal and Transitional Medicine, Children's National Medical Center, Washington, DC, USA [2] Department of Pediatrics, The George Washington University School of Medicine, Washington, DC, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: du Plessis
mesh_terms: D000328:Adult; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D007231:Infant, Newborn; D008297:Male; D012372:ROC Curve; D016019:Survival Analysis