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.Aim:This study was initiated to measure th e changes in HRV in neonates during extracorporeal membrane oxygenation(ECMO)a nd recovery from severe respiratory and circulatory failure.Moreover,we compar ed our data with HRV data of healthy newborns and we investigated the difference s in HRV parameters between ECMO-survivors and non-survivors.Study design:Th is study is of an observational character.We performed short-term recordings o f heart rate variability in 14 neonates during ECMO and recovery.We computed ti me-and frequency-domain HRV parameters.Results:ECMO significantly affects ti me-domain HRV parameters.Severe neonatal illness causes a significant reductio n of all calculated HRV parameters;clinical recovery is accompanied by an incre ase of HRV.In comparison with normative data of healthy newborns,however,HRV remains impaired.The ECMO-development ratio s eparated the non-survivors from the survivors during ECMO therapy.Conclusions:During severe neonatal illness,HRV is impaired.It remains to be clarified whe ther the impairment of HRV during severe illness can predict the neurological ou tcome.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.
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