Heart Rate Variability as a Prognostic Tool for Gastroschisis Infants in the Neonatal Intensive Critical Unit

Chioma Moneme; Sherry L Kausch; Briana M Belmonte; Mark A Fleming Ii; Daniel E Levin; Brynne A Sullivan

doi:10.1055/a-2244-0148

Heart Rate Variability as a Prognostic Tool for Gastroschisis Infants in the Neonatal Intensive Critical Unit

Am J Perinatol. 2024 Feb 28. doi: 10.1055/a-2244-0148. Online ahead of print.

Authors

Chioma Moneme¹, Sherry L Kausch², Briana M Belmonte³, Mark A Fleming Ii¹, Daniel E Levin^{1

4}, Brynne A Sullivan²

Affiliations

¹ Department of Surgery, The University of Virginia, Charlottesville, Virginia.
² Department of Pediatrics, The University of Virginia, Charlottesville, Virginia.
³ School of Medicine, The University of Virginia, Charlottesville, Virginia.
⁴ Department of Pediatric Surgery, The University of Virginia, Charlottesville, Virginia.

PMID: 38216140
DOI: 10.1055/a-2244-0148

Abstract

Objective: Gastroschisis is the most common congenital abdominal wall defect, with an increasing incidence. It results in extrusion of abdominal contents with associated delayed intestinal motility. Abnormal heart rate characteristics (HRCs) such as decreased variability occur due to the inflammatory response to sepsis in preterm infants. This study aimed to test the hypothesis that infants with gastroschisis have decreased heart rate variability (HRV) after birth and that this physiomarker may predict outcomes.

Study design: We analyzed heart rate data from and clinical variables for all infants admitted with gastroschisis from 2009 to 2020.

Results: Forty-seven infants were admitted during the study period and had available data. Complex gastroschisis infants had reduced HRV after birth. For those with sepsis and necrotizing enterocolitis, abnormal HRCs occurred early in the course of illness.

Conclusion: Decreased HRV was associated with complex gastroschisis. Infants in this group experienced complications that prolonged time to full enteral feeding and time on total parenteral nutrition.

Key points: · Infants with gastroschisis can be classified into two subcategories, simple and complex disease.. · Those with complex disease often require prolonged stays in the neonatal intensive care unit and costly hospitalizations. We hypothesized that infants with complex gastroschisis are more likely to have abnormal HRC due to intestinal inflammation.. · In this study, we identified associations between abnormal HRV, heart rate characteristicHRC, and the development of gastroschisis complications. Additionally, we described differences in clinical characteristics between infants with complex versus simple gastroschisis..