Nagiub Mohamed, Alton Karen, Avula Varun, Hagglund Karen, Anne Premchand
Department of Pediatric Cardiology, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, VA, USA.
Department of Pediatrics, St. John Providence Children's Hospital, Detroit, MI, USA.
SAGE Open Med. 2014 Nov 6;2:2050312114556525. doi: 10.1177/2050312114556525. eCollection 2014.
To determine whether heart rate variability parameters vary between in-utero drug-exposed infants and controls. To determine correlations between Finnegan score and heart rate variability parameters. To differentiate those drug-exposed infants who require treatment from those infants who do not.
A total of 24 jaundiced control subjects and 25 in-utero drug-exposed infants were enrolled. The Finnegan score and an electrocardiographic rhythm strip were obtained at 4-h intervals. RR intervals (time between consecutive R waves) were manually tabulated from the rhythm strip and analyzed. Time-domain heart rate variability parameters were calculated and analyzed for both groups.
Heart rate variability parameters were cumulatively lower over 3 days in in-utero drug-exposed infants compared with controls (p < 0.05). Root mean square of differences of standard deviation of RR intervals on first day of life, and standard deviation of RR intervals, percentage of consecutive RR intervals greater than 50 ms, and root mean square of differences of standard deviation of RR intervals on the second day of life were significantly lower between in-utero drug-exposed infants and control infants. Three out of five parameters were significantly lower in in-utero drug-exposed infants pre-treatment versus post-treatment (p = 0.001, p = 0.0001, and p = 0.021, respectively). Root mean square of differences of standard deviation of RR intervals was able to differentiate in-utero drug-exposed infants requiring opiate therapy and in-utero drug-exposed infants that did not (p = 0.02).
Heart rate variability analysis can contribute to the management of in-utero drug-exposed infants. Heart rate variability could be used in dose titration.
确定子宫内药物暴露婴儿与对照组之间心率变异性参数是否存在差异。确定芬尼根评分与心率变异性参数之间的相关性。区分需要治疗的药物暴露婴儿和不需要治疗的婴儿。
共纳入24名黄疸对照组受试者和25名子宫内药物暴露婴儿。每隔4小时获取芬尼根评分和一份心电图节律条。从节律条中手动列出RR间期（连续R波之间的时间）并进行分析。计算并分析两组的时域心率变异性参数。
与对照组相比，子宫内药物暴露婴儿在3天内的心率变异性参数累计较低（p<0.05）。子宫内药物暴露婴儿与对照婴儿相比，出生第一天RR间期标准差的差值均方根、RR间期标准差、连续RR间期大于50毫秒的百分比以及出生第二天RR间期标准差的差值均方根显著更低。子宫内药物暴露婴儿治疗前与治疗后，五个参数中有三个显著更低（分别为p = 0.001、p = 0.0001和p = 0.021）。RR间期标准差的差值均方根能够区分需要阿片类药物治疗的子宫内药物暴露婴儿和不需要治疗的子宫内药物暴露婴儿（p = 0.02）。
心率变异性分析有助于子宫内药物暴露婴儿的管理。心率变异性可用于剂量滴定。
