Mortality reduction by heart rate characteristic monitoring in very low birth weight neonates: A randomized trial

Joseph Randall Moorman, Waldemar A. Carlo, John Kattwinkel, Robert L. Schelonka, Peter J. Porcelli, Christina T. Navarrete, Eduardo Bancalari, Judy L. Aschner, Marshall Whit Walker, Jose A. Perez, Charles Palmer, George J. Stukenborg, Douglas E. Lake, Thomas Michael O'Shea

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172 Scopus citations

Abstract

Objective: To test the hypothesis that heart rate characteristics (HRC) monitoring improves neonatal outcomes. Study design: We conducted a two-group, parallel, individually randomized controlled clinical trial of 3003 very low birth weight infants in 9 neonatal intensive care units. In one group, HRC monitoring was displayed; in the other, it was masked. The primary outcome was number of days alive and ventilator-free in the 120 days after randomization. Secondary outcomes were mortality, number of ventilator days, neonatal intensive care unit stay, and antibiotic use. Results: The mortality rate was reduced in infants whose HRC monitoring was displayed, from 10.2% to 8.1% (hazard ratio, 0.78; 95% CI, 0.61-0.99; P =.04; number needed to monitor = 48), and there was a trend toward increased days alive and ventilator-free (95.9 of 120 days compared with 93.6 in control subjects, P =.08). The mortality benefit was concentrated in infants with a birth weight <1000 g (hazard ratio, 0.74; 95% CI, 0.57-0.95; P =.02; number needed to monitor = 23). There were no significant differences in the other outcomes. Conclusion: HRC monitoring can reduce the mortality rate in very low birth weight infants.

Original languageEnglish (US)
Pages (from-to)900-906.e1
JournalJournal of Pediatrics
Volume159
Issue number6
DOIs
StatePublished - Dec 2011

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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    Moorman, J. R., Carlo, W. A., Kattwinkel, J., Schelonka, R. L., Porcelli, P. J., Navarrete, C. T., Bancalari, E., Aschner, J. L., Whit Walker, M., Perez, J. A., Palmer, C., Stukenborg, G. J., Lake, D. E., & Michael O'Shea, T. (2011). Mortality reduction by heart rate characteristic monitoring in very low birth weight neonates: A randomized trial. Journal of Pediatrics, 159(6), 900-906.e1. https://doi.org/10.1016/j.jpeds.2011.06.044