Heart rate variability and electroencephalography in Infants with hypoxic ischaemic encephalopathy

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dc.contributor.advisor Boylan, Geraldine B. en
dc.contributor.advisor Stevenson, Nathan J. en
dc.contributor.advisor Filan, Peter M. en
dc.contributor.author Goulding, Robert Michael David
dc.date.accessioned 2018-06-18T11:45:09Z
dc.date.available 2018-06-18T11:45:09Z
dc.date.issued 2017
dc.date.submitted 2017
dc.identifier.citation Goulding, R. M. D. 2017. Heart rate variability and electroencephalography in Infants with hypoxic ischaemic encephalopathy. PhD Thesis, University College Cork. en
dc.identifier.endpage 303 en
dc.identifier.uri http://hdl.handle.net/10468/6365
dc.description.abstract Hypoxic-ischaemic encephalopathy (HIE) remains a significant cause of neurological injury in the newborn. HIE is associated with altered autonomic function. Heart rate variability (HRV) is a direct measure of autonomic control and this thesis aims to investigate the use of HRV as a reliable, routinely recorded physiological marker to identify HIE severity, seizure activity, and predict long-term outcome. Measures of HRV were calculated on a cohort of full-term infants with HIE, recruited from 2003-2012, prior to and following the introduction of therapeutic hypothermia (TH) in the neonatal intensive care unit. Simultaneous, 1h periods of EEG and ECG activity were recorded from 6h-90h after birth. EEG activity was used to grade epochs as mild, moderate, or severe. Normalised-RR intervals were used to calculate seven HRV features from the ECG signal: Mean (mean NN), standard deviation (SDNN), triangular interpolation (TINN), power in high frequency (HF), low frequency (LF), very low frequency bands (VLF), and LF/HF ratio. There were significant correlations between HRV and EEG grade in normothermic (r = -0.45 to -0.33; n=44) and hypothermic groups (r = -0.39 to -0.22 ; n=74). In infants with moderate HIE, there were significant differences between normothermic and hypothermic groups (HF: p=0.016, LF/HF ratio: p=0.006, mean NN: p<0.001). HRV was significantly associated with outcome in both normothermic and hypothermic groups (normothermic at 24h, 48h and hypothermic 12h, 24h, and 48h after birth). Infants with neonatal seizures and severe HIE had an increase in HRV during electrographic seizures (TINN: p= 0.034, VLF: p=0.028, LF: p=0.006, HF: p=0.015). The measurement of autonomic function with HRV has potential as a diagnostic and prognostic tool in infants with HIE. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher University College Cork en
dc.rights © 2017, Robert Michael David Goulding. en
dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/3.0/ en
dc.subject Electroencephalography en
dc.subject Neonates en
dc.subject Heart rate variability en
dc.subject Hypoxic ischaemic encephalopathy en
dc.title Heart rate variability and electroencephalography in Infants with hypoxic ischaemic encephalopathy en
dc.type Doctoral thesis en
dc.type.qualificationlevel Doctoral en
dc.type.qualificationname PhD en
dc.internal.availability Full text not available en
dc.check.info Restricted to everyone for ten years en
dc.check.date 2028-06-18
dc.description.version Accepted Version
dc.contributor.funder Science Foundation Ireland en
dc.description.status Not peer reviewed en
dc.internal.school Paediatrics and Child Health en
dc.check.reason Not applicable en
dc.check.opt-out Not applicable en
dc.thesis.opt-out false
dc.check.entireThesis Entire Thesis Restricted
dc.check.embargoformat Both hard copy thesis and e-thesis en
ucc.workflow.supervisor g.boylan@ucc.ie
dc.internal.conferring Autumn 2017 en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Principal Investigator Programme (PI)/10/IN.1/B3036/IE/Pattern RecognitIon Systems for continuous neurological Monitoring in NEOnates [NEOPRISM]./ en
dc.relation.project info:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/ en

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© 2017, Robert Michael David Goulding. Except where otherwise noted, this item's license is described as © 2017, Robert Michael David Goulding.
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