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

doi:10.1038/pr.2016.21

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 journal › Article › Academic › peer-review

Abstract

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 language	English
Pages (from-to)	907-915
Journal	Pediatric Research
Volume	79
Issue number	6
DOIs	https://doi.org/10.1038/pr.2016.21
Publication status	Published - Jun 2016

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10.1038/pr.2016.21

Cite this

@article{d1ba1f0e11ec44f6bbbc9ecb6f437834,

title = "Comparison of ECG-based physiological markers for hypoxia in a preterm ovine model",

abstract = "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 (",

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

year = "2016",

month = jun,

doi = "10.1038/pr.2016.21",

language = "English",

volume = "79",

pages = "907--915",

journal = "Pediatric Research",

issn = "0031-3998",

publisher = "Nature Publishing Group",

number = "6",

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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 (

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DO - 10.1038/pr.2016.21

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SN - 0031-3998

VL - 79

SP - 907

EP - 915

JO - Pediatric Research

JF - Pediatric Research

IS - 6

ER -