Topics

Heart Rate Variability in Febrile Young Infants

2019-09-30 07:06:53 | BioPortfolio

Summary

Febrile infants younger than 3 months old present a diagnostic dilemma to the emergency physician. Tension remains between the need for early aggressive intervention among patients with suspected sepsis and the global phenomena of increasing antibiotic resistance.

The investigators aim to: (1) To study the association between heart rate variability (HRV) and the presence of a serious infection (SI) among infants younger than 3 months old. The investigators hypothesize that a reduced HRV is associated with the presence of SI. (2) To compare HRV between febrile infants < 3 months with non-febrile infants. The investigators hypothesize that the variability will be reduced in febrile infants with SIs when compared to non-febrile well infants, but not among febrile infants without SIs when compared to non-febrile well infants. (3) To study if HRV will provide incremental diagnostic information over current triage tools.

Description

Febrile young infants younger than 3 months old present a diagnostic dilemma to the pediatric emergency department (ED) physician. The potential for a missed serious infection (SI) poses the threat of premature death and long-term disability among these infants. Despite decreasing early-onset neonatal sepsis rates due to obstetric prevention strategies, high rates of hospitalization and administration of parenteral antibiotics occur in this age group. Continual tension remains between the need for early and aggressive intervention among patients suspected with sepsis and the global phenomena of increasing antibiotic resistance. Research networks have attempted to build diagnostic algorithms to guide the identification of these ill infants. These are often useful as adjuncts to the clinician's gestalt, but generalizability remains questionable.

Vital signs are of paramount importance in recognizing ill children and have been used in pediatric early warning system scores (PEWS) and various triage systems. Vital signs have resurfaced as the focus of research in recent years, with various groups purposing to update evidence-based normal heart rate ranges among children. Normative heart rate ranges are infamously difficult to define due to the hemodynamic lability in these young infants, multiple confounders for abnormal heart rate, and the variable physiological response during acute stress states.

Previous pilot data showed that the Advanced Paediatric Life Support (APLS) and Fleming (<10th or >90th centile) guidelines performed with the highest sensitivity (66.0% and 62.6%, respectively) and the highest Negative Predictive Value (NPV) (73.3% and 71.4%, respectively). No single guideline reached a sensitivity of greater than 70%.

Objectives and Hypothesis

1. To study the association between heart rate variability (HRV) and the presence of a serious infection (SI) among infants younger than 3 months old. The investigators hypothesize that a reduced HRV is associated with the presence of SI.

2. To compare HRV between febrile infants < 3 months with non-febrile infants. The investigators hypothesize that the variability will be reduced in febrile infants with SIs when compared to non-febrile well infants, but not among febrile infants without SIs when compared to non-febrile well infants.

3. To study if HRV will provide incremental diagnostic information over current triage tools.

Study Design

Conditions

Heart Rate

Intervention

Single lead ECG

Location

KK Women's and Children' Hospital
Singapore
Singapore
229899

Status

Recruiting

Source

KK Women's and Children's Hospital

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-09-30T07:06:53-0400

Clinical Trials [2308 Associated Clinical Trials listed on BioPortfolio]

Attain Model 4196 Left Ventricular (LV) Lead

Heart failure is a progressive disease that decreases the pumping action of the heart. This may cause a backup of fluid in the heart and may result in heart beat changes. When there are ch...

Heart Rate Variability (HRV) in Pituitary Adenoma

Several studies have been reported that heart rate is known to be associated with prognosis in chronic diseases and acute diseases. For example, a decrease in heart rate following myocardi...

Model 4296 Left Ventricular (LV) Lead Study

This study is designed to show that a new lead, which paces the left bottom chamber (left ventricle) of the heart, is safe. Using a lead on the left side of the heart has been shown to pot...

Effect of Chronic Changes in Heart Rate on Congestive Heart Failure

This will be a double blind randomized crossover study of patients with congestive heart failure and a heart rate dependent upon a permanent pacemaker. Thus, at all times the heart rate ca...

Attain Success Trial

The purpose of the study is to assess lead implant success and complication rate using the Medtronic Attain Family of left-heart leads and delivery catheters.

PubMed Articles [20345 Associated PubMed Articles listed on BioPortfolio]

The heart rate method for estimating oxygen uptake: analyses of reproducibility using a range of heart rates from commuter walking.

The heart rate method, based on the linear relation between heart rate and oxygen uptake, is potentially valuable to monitor intensity levels of physical activities. However, this depends not least on...

A computationally efficient algorithm to obtain an accurate and interpretable model of the effect of circadian rhythm on resting heart rate.

Wrist-worn wearable devices equipped with heart rate sensors have become increasingly popular. The ability to correctly interpret the collected data is fundamental to analyse users well-being and perf...

Fever increases heart rate and respiratory rate; a prospective observational study of acutely admitted medical patients.

The relationship between increase in body temperature, heart rate, and respiratory rate has only been studied in young, healthy subjects.

Elective or Emergency Heart Transplantation: Cost Comparison in a Single Center.

Heart transplantation (HT) is the treatment of choice for selected cases of advanced heart failure. There is an increasing rate of emergency HT in our country. The aim of this study was to determine t...

Heart Rate Variability and Heart Rate Recovery in Lung Cancer Survivors Eligible for Long-Term Cure.

Lung cancer survivors are at risk for physical fitness and autonomic function impairments. In a cross-sectional study of consecutive lung cancer survivors post-curative intent therapy, we assessed and...

Medical and Biotech [MESH] Definitions

The heart rate of the FETUS. The normal range at term is between 120 and 160 beats per minute.

Methods, techniques, and processes by which HEART RATE is measured.

A pumping mechanism that duplicates the output, rate, and blood pressure of the natural heart. It may replace the function of the entire heart or a portion of it, and may be an intracorporeal, extracorporeal, or paracorporeal heart. (Dorland, 28th ed)

INFLAMMATION of the sac surrounding the heart (PERICARDIUM) due to MYCOBACTERIUM TUBERCULOSIS infection. Pericarditis can lead to swelling (PERICARDIAL EFFUSION), compression of the heart (CARDIAC TAMPONADE), and preventing normal beating of the heart.

The number of times the HEART VENTRICLES contract per unit of time, usually per minute.

More From BioPortfolio on "Heart Rate Variability in Febrile Young Infants"

Quick Search

Relevant Topics

Infectious-diseases
Antiretroviral Therapy Clostridium Difficile Ebola HIV & AIDS Infectious Diseases Influenza Malaria Measles Sepsis Swine Flu Tropical Medicine Tuberculosis Infectious diseases are caused by pathogenic...

MRSA (methicillin-resistant Staphylococcus aureus)
MRSA (methicillin-resistant Staphylococcus aureus) is a family of bacteria with resistance to one or more major antibiotics. There are currently 17 different strains of MRSA. Two particular strains, EMRSA15 and EMRSA16  account for 96% of MRSA blood...

Cardiovascular disease (CVD)
Acute Coronary Syndromes (ACS) Blood Cardiovascular Dialysis Hypertension Stent Stroke Vascular Cardiovascular disease (CVD) includes all the diseases of the heart and circulation including coronary heart disease (angina...


Searches Linking to this Trial