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BMC Pediatrics
Published in: BMC Pediatrics 1/2019

Open Access 01-12-2019 | Encephalopathy | Research article

Severity of hypoxic ischemic encephalopathy and heart rate variability in neonates: a systematic review

Authors: Mads Andersen, Ted C. K. Andelius, Mette V. Pedersen, Kasper J. Kyng, Tine B. Henriksen

Published in: BMC Pediatrics | Issue 1/2019

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Abstract

Background

Several studies have investigated heart rate variability (HRV) as a biomarker for acute brain injury in hypoxic ischemic encephalopathy (HIE). However, the current evidence is heterogeneous and needs further reviewing to direct future studies. We aimed to systematically review whether HIE severity is associated with HRV.

Methods

This systematic review was conducted according to the preferred reporting items for systematic review and meta analyses (PRISMA). We included studies comparing neonates with severe or moderate HIE with neonates with mild or no HIE with respect to different HRV measures within 7 days of birth. Article selection and quality assessment was independently performed by two reviewers. Risk of bias and strength of evidence was evaluated by the Newcastle-Ottawa scale (NOS) and the Grading of Recommendations Assessment, Development and Evaluation (GRADE).

Results

We screened 1187 studies. From these, four observational studies with 248 neonates were included. For all HRV measures, the strength of evidence was very low. Neonates with severe or moderate HIE showed a reduction in most HRV measures compared to neonates with mild or no HIE with a greater reduction in those with severe HIE.

Conclusions

Moderate and severe HIE was associated with a reduction in most HRV measures. Accordingly, HRV is a potential biomarker for HIE severity during the first week of life. However, the uncertainty calls for more studies.
Appendix
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Metadata
Title
Severity of hypoxic ischemic encephalopathy and heart rate variability in neonates: a systematic review
Authors
Mads Andersen
Ted C. K. Andelius
Mette V. Pedersen
Kasper J. Kyng
Tine B. Henriksen
Publication date
01-12-2019
Publisher
BioMed Central
Keyword
Encephalopathy
Published in
BMC Pediatrics / Issue 1/2019
Electronic ISSN: 1471-2431
DOI
https://doi.org/10.1186/s12887-019-1603-7

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