Comparison of ECG-based physiological markers for hypoxia in a preterm ovine model

Alex Zwanenburg, Ben J. M. Hermans, Peter Andriessen, Hendrik J. Niemarkt, Reint K. Jellema, Daan R. M. G. Ophelders, Rik Vullings, Tim G. A. M. Wolfs, Boris W. Kramer, Tammo Delhaas*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


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 (
Original languageEnglish
Pages (from-to)907-915
JournalPediatric Research
Issue number6
Publication statusPublished - Jun 2016

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