Heart rate variability and electroencephalography in Infants with hypoxic ischaemic encephalopathy

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dc.check.date2028-06-18
dc.check.embargoformatBoth hard copy thesis and e-thesisen
dc.check.entireThesisEntire Thesis Restricted
dc.check.infoRestricted to everyone for ten yearsen
dc.check.opt-outNot applicableen
dc.check.reasonNot applicableen
dc.contributor.advisorBoylan, Geraldine B.en
dc.contributor.advisorStevenson, Nathan J.en
dc.contributor.advisorFilan, Peter M.en
dc.contributor.authorGoulding, Robert Michael David
dc.contributor.funderScience Foundation Irelanden
dc.date.accessioned2018-06-18T11:45:09Z
dc.date.available2018-06-18T11:45:09Z
dc.date.issued2017
dc.date.submitted2017
dc.description.abstractHypoxic-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.description.statusNot peer revieweden
dc.description.versionAccepted Version
dc.format.mimetypeapplication/pdfen
dc.identifier.citationGoulding, R. M. D. 2017. Heart rate variability and electroencephalography in Infants with hypoxic ischaemic encephalopathy. PhD Thesis, University College Cork.en
dc.identifier.endpage303en
dc.identifier.urihttps://hdl.handle.net/10468/6365
dc.language.isoenen
dc.publisherUniversity College Corken
dc.relation.projectinfo: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.projectinfo:eu-repo/grantAgreement/SFI/SFI Research Centres/12/RC/2272/IE/Irish Centre for Fetal and Neonatal Translational Research (INFANT)/en
dc.rights© 2017, Robert Michael David Goulding.en
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/3.0/en
dc.subjectElectroencephalographyen
dc.subjectNeonatesen
dc.subjectHeart rate variabilityen
dc.subjectHypoxic ischaemic encephalopathyen
dc.thesis.opt-outfalse
dc.titleHeart rate variability and electroencephalography in Infants with hypoxic ischaemic encephalopathyen
dc.typeDoctoral thesisen
dc.type.qualificationlevelDoctoralen
dc.type.qualificationnamePhDen
ucc.workflow.supervisorg.boylan@ucc.ie
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