TY - JOUR
T1 - Comparison of ECG-based physiological markers for hypoxia in a preterm ovine model
AU - Zwanenburg, Alex
AU - Hermans, Ben J. M.
AU - Andriessen, Peter
AU - Niemarkt, Hendrik J.
AU - Jellema, Reint K.
AU - Ophelders, Daan R. M. G.
AU - Vullings, Rik
AU - Wolfs, Tim G. A. M.
AU - Kramer, Boris W.
AU - Delhaas, Tammo
PY - 2016/6
Y1 - 2016/6
N2 - Background: Current methods for assessing perinatal hypoxic conditions did not improve infant outcomes. Various waveform-based and interval-based ECG markers have been suggested, but not directly compared. We compare performance of ECG markers in a standardized ovine model for fetal hypoxia. Methods: Sixty-nine fetal sheep of 0.7 gestation had ECG recorded 4 h before, during, and 4 h after a 25-min period of umbilical cord occlusion (UCO), leading to severe hypoxia. Various ECG markers were calculated, among which were heart rate (HR), HR-corrected ventricular depolarization/repolarization interval (QT(c)), and ST-segment analysis (STAN) episodic and baseline rise markers, analogue to clinical STAN device alarms. Performance of interval-and waveform-based ECG markers was assessed by correlating predicted and actual hypoxic/normoxic state. Results: Of the markers studied, HR and QT(c) demonstrated high sensitivity (>= 86%), specificity (>= 96%), and positive predictive value (PPV) (>= 86%) and detected hypoxia in >= 90% of fetuses at 4 min after UCO. In contrast, STAN episodic and baseline rise markers displayed low sensitivity (
AB - Background: Current methods for assessing perinatal hypoxic conditions did not improve infant outcomes. Various waveform-based and interval-based ECG markers have been suggested, but not directly compared. We compare performance of ECG markers in a standardized ovine model for fetal hypoxia. Methods: Sixty-nine fetal sheep of 0.7 gestation had ECG recorded 4 h before, during, and 4 h after a 25-min period of umbilical cord occlusion (UCO), leading to severe hypoxia. Various ECG markers were calculated, among which were heart rate (HR), HR-corrected ventricular depolarization/repolarization interval (QT(c)), and ST-segment analysis (STAN) episodic and baseline rise markers, analogue to clinical STAN device alarms. Performance of interval-and waveform-based ECG markers was assessed by correlating predicted and actual hypoxic/normoxic state. Results: Of the markers studied, HR and QT(c) demonstrated high sensitivity (>= 86%), specificity (>= 96%), and positive predictive value (PPV) (>= 86%) and detected hypoxia in >= 90% of fetuses at 4 min after UCO. In contrast, STAN episodic and baseline rise markers displayed low sensitivity (
U2 - 10.1038/pr.2016.21
DO - 10.1038/pr.2016.21
M3 - Article
C2 - 26866904
SN - 0031-3998
VL - 79
SP - 907
EP - 915
JO - Pediatric Research
JF - Pediatric Research
IS - 6
ER -