Diminished vagal tone is a predictive biomarker of necrotizing enterocolitis-risk in preterm infants (pages 832–840)
K. K. Doheny, C. Palmer, K. N. Browning, P. Jairath, D. Liao, F. He and R. A. Travagli
Version of Record online: 11 APR 2014 | DOI: 10.1111/nmo.12337
Prognostic identification of infants at risk for necrotizing enterocolitis (NEC) is required as a matter of urgency. We tested the hypothesis that the high frequency (HF) component of heart rate variability (HRV) representative of vagal tone and the cholinergic anti-inflammatory reflex may be used in infants as a predictive biomarker for NEC-risk before the onset of clinical NEC. Spectral analysis of surface electrocardiogram was done in ‘healthy’ preterm infants at rest on day 5–8 of life and associated with later diagnosis of NEC. The risk (odds ratio) of developing NEC 0.5–20 days in advance of clinical symptoms was 10 per every one SD decrease in HF-HRV (vagal tone). Our preliminary data indicate that HF-HRV may serve as a potential, non-invasive predictive biomarker of NEC-risk in NICU infants.