The HeRO score: Enhancing prognosis and predicting nosocomial infections in newborns – insights from the neonatal intensive care unit Fatiha Bennaoui, Abdessamad Lalaoui, Nadia El Idrissi Slitine, Nabila Soraa, Fadl Mrabih Rabou Maoulainine J Neonatal Perinatal Med. (2024) Jan.

Impact of race on heart rate characteristics monitoring in very low birth weight infants Brynne A. Sullivan, Camille J. Hochheimer, Pavel Chernyavskiy, William E. King and Karen D. Fairchild. Ped. Res.. (2023) Jan 17.

Cost-effectiveness analysis of heart rate characteristics monitoring to improve survival for very low birth weight infants William E. King, Waldemar A. Carlo, T. Michael O’Shea and Robert L. Schelonka. Front. Health Serv.. (2022) Sept 7.

Introducing heart rate variability monitoring combined with biomarker screening into a level IV NICU: a prospective implementation study Şerife Kurul, Nicky van Ackeren, Tom G Goos, Christian R B Ramakers, Jasper V Been, René F Kornelisse, Irwin K M Reiss, Sinno H P Simons, H Rob Taal. Eur J Pediatrics. (2022) Jul 4; PMID: 35786750 DOI: 10.1007/s00431-022-04534-4

Monitoring of heart rate characteristics to detect neonatal sepsis Rio L, Ramelet AS, Ballabeni P, Stadelmann C, Asner S, Giannoni E. Pediatr Res.. (2021) Dec 16; doi: 10.1038/s41390-021-01913-9. Online ahead of print.

Framework for considering abnormal heart rate characteristics and other signs of sepsis in very low birth weight infants Kumar RS, Otero NA, Abubakar MO, Elliott MR, Wiggins JY, Sharif MM, Sullivan BA, Fairchild KD. Am J Perinatol.. (2021) Dec 7. doi: 10.1055/a-1715-3727. Online ahead of print.

Multivariable predictive models of death or neurodevelopmental impairment among extremely low birth weight infants using heart rate characteristics King WE, Carlo WA, O’Shea TM, Schelonka RL. J Pediatr.. (2021) Nov 16;S0022-3476(21)01098-2. doi: 10.1016/j.jpeds.2021.11.026.

Risk of Mortality for Patients with Persistently Elevated HeRO King, WE. Neo Intensive Care. (2021) Fall NIC 34-4:19-21.

Sepsis and Mortality Prediction in Very Low Birth Weight Infants: Analysis of HeRO and nSOFA Zeigler AC, Ainsworth JE, Fairchild KD, Wynn JL, Sullivan BA. Am J Pernatol. (2021) May 10. doi: 10.1055/s-0041-1728829.

Urinary tract infections in very low birthweight infants: A two-center analysis of microbiology, imaging and heart rate characteristics Aviles-Otero N, Ransom M, Weitkamp J, Charlton JR, Sullivan BA, Kaufman DA, Fairchild KD. J Neonatal Perinatal Med.. (2020) Oct 27. doi: 10.3233/NPM-200513.

Trajectories of the heart rate characteristics index, a physiomarker of sepsis in premature infants, predict Neonatal ICU mortality Zimmet AM, Sullivan BA, Moorman JR, Lake DE, Ratcliffe SJ. JRSM Cardiovasc Dis.. (2020) Aug 5;9:2048004020945142. doi: 10.1177/2048004020945142.

Heart rate variability as possible marker of brain damage in neonates with hypoxic ischemic encephalopathy: a systematic review. Bersani I, Piersigilli F, Gazzolo D, Campi F, Savarese I, Dotta A, Tamborrino PP, Auriti C, Di Mambro C. Eur J Pediatr.. (2020) Nov 27:1-11. doi: 10.1007/s00431-020-03882-3.

Heart Rate Characteristics Monitoring and Viral Infection in the Neonatal Intensive Care Unit King WE, Perez J. Neo Today. (2020) October, Volume 15, Issue 10, pp 53-58.

A narrative review of heart rate and variability in sepsis Wee BYH, Lee JH, Mok YH, Chong SL. Ann Transl Med.. 2020;8(12):768. doi: 10.21037/atm-20-148.

HeRO Monitoring: Does It Lead to Unnecessary Testing and Treatment? King WE. Neo Today. (2020) June, Volume 15, Issue 6, pp 33-38.

Continuous vital sign analysis for predicting and preventing neonatal diseases in the twenty-first century: big data to the forefront Navin Kumar, Gangaram Akangire, Brynne Sullivan, Karen Fairchild, and Venkatesh Sampath Pediatr Res (2020) 2020; 87(2): 210–220. Published online 2019 Aug 4. doi: 10.1038/s41390-019-0527-0

Predicting Extubation Outcomes Using Heart Rate Characteristics Index in Preterm Infants: A Cohort Study Chakraborty M, Watkins WJ, Tansey K, King WE, Banerjee S. Eur Respir J. (2020) May 22:1901755. doi: 10.1183/13993003.01755-2019. Online ahead of print.

A Case Study in Evaluating the Clinical Utility of Early Warning Systems: HeRO King, WE. Neo Intensive Care. (2020) Spring NIC 33-2:15-19.

Mortality and Neurodevelopmental Outcomes in the Heart Rate Characteristics Monitoring Randomized Controlled Trial. Schelonka RL, Carlo WA, Bauer CR, Peralta-Carcelen M, Phillips V, Helderman J, Navarrete CT, Moorman JR, Lake DE, Kattwinkel J, Fairchild KD, O’Shea TM. J Pediatr. (2020) Feb 04. pii: S0022-3476(19)31745-7. doi: 10.1016/j.jpeds.2019.12.066. [Epub ahead of print]

Correlation Between Heart Rate Characteristic Index Score and Severity of Brain Injury in Neonates With Hypoxic-Ischemic Encephalopathy. Kayton A, DeGrazia M, Smith D, Sharpe E, Perez JA, Weiss MD. Adv Neonatal Care.. (2019) Dec 30. doi: 10.1097/ANC.0000000000000686. [Epub ahead of print]

Meningitis, urinary tract, and bloodstream infections in very low birth weight infants enrolled in a heart rate characteristics monitoring trial. Weitkamp JH, Aschner JL, Carlo WA, Bancalari E, Perez JA, Navarrete CT, Schelonka RL, Whit Walker M, Porcelli P Jr, O’Shea TM, Palmer C, Grossarth S, Lake DE, Fairchild KD. Pediatr Res.. (2020) Jun;87(7):1226-1230. doi: 10.1038/s41390-019-0701-4. Epub 2019 Dec 4.

Diffusing an Innovation: Clinician Perceptions of Continuous Predictive Analytics Monitoring in Intensive Care. Kitzmiller RR, Vaughan A, Skeeles-Worley A, Keim-Malpass J, Yap TL, Lindberg C, Kennerly S, Mitchell C, Tai R, Sullivan BA, Anderson R, Moorman JR. Appl Clin Inform. (2019) Mar;10(2):295-306. doi: 10.1055/s-0039-1688478.

Heart-rate-characteristic monitoring decreases NICU length of stay. Fairchild KD. J Pediatr. (2018) Nov;202:330-333. doi: 10.1016/j.jpeds.2018.08.055.

Neonatal Intensive Care Unit Length of Stay Reduction by Heart Rate Characteristics Monitoring. Swanson JR, King WE, Sinkin RA, Lake DE, Carlo WA, Schelonka RL, Porcelli PJ, Navarrete CT, Bancalari E, Aschner JL, Perez JA, O’Shea TM, Walker MW. J Pediatr. (2018) Jul;198:162-167. doi: 10.1016/j.jpeds.2018.02.045. Epub 2018 Apr 24.

Cross-Correlation of Heart Rate and Oxygen Saturation in Very Low Birthweight Infants: Association with Apnea and Adverse Events. Fairchild KD, Lake DE. Am J Perinatol. (2018) Apr;35(5):463-469. doi: 10.1055/s-0037-1608709. Epub 2017 Nov 15.

Predicting Extubation Outcomes-A Model Incorporating Heart Rate Characteristics Index. Goel N, Chakraborty M, Watkins WJ, Banerjee S. J Pediatr. (2018) Jan 10. pii: S0022-3476(17)31593-7. doi: 10.1016/j.jpeds.2017.11.037.

Dexamethasone effect on heart rate variability in preterm infants on mechanical ventilation Alonzo CJ, Fairchild KD. J Neonatal Perinatal Med. (2017) 10(4):425-430. doi: 10.3233/NPM-16157.

Reduced NICU Length of Stay Using Heart Rate Characteristics Monitoring. Swanson, JR, King W, Carlo W, Sinkin RA, Schelonka R, Porcelli PJ, Navarrete C, Bancalari E, Aschner JL, Perez J, Palmer C, O’Shea M, Walker W. PAS Conference Abstract (2017).

Cost Analysis of Heart Rate Characteristics Monitoring in the NICU. Karvonen KL, Vergales J, Sinkin RA, Swanson JR. PAS Conference Abstract (2017).

Vital signs and their cross-correlation in sepsis and NEC: a study of 1,065 very-low-birth-weight infants in two NICUs. Fairchild KD, Lake DE, Kattwinkel J, Moorman JR, Bateman DA, Grieve PG, Isler JR, Sahni R. Pediatr Res. (2017) Feb;81(2):315-321. doi: 10.1038/pr.2016.215.

Early Heart Rate Characteristics Predict Death and Morbidities in Preterm Infants. Sullivan BA, McClure C, Hicks J, Lake DE, Moorman JR, Fairchild KD. J Pediatr. (2016) Apr 21. pii: S0022-3476(16)00423-6. doi: 10.1016/j.jpeds.2016.03.042.

Predictive monitoring for sepsis and necrotizing enterocolitis to prevent shock. Sullivan BA, Fairchild KD. J Semin Fetal Neonatal Med. (2015) Aug;20(4):255-61. doi: 10.1016/j.siny.2015.03.006. Epub 2015 Mar 29.

Heart Rate Characteristics Index Score: È Utile Nel Predire La Sepsi Neonatale? Pugni L, Ronchi A, Bizzarri B, Piestrasanta C, Araimo G, Ghirardi B, Casciati MC, Perniciaro S, Casartelli M, Mosca F. J La Pediatria Medica e Chirurgica – Medical and Surgical Pediatrics. (2015) 37(1):47-8.

Abnormal heart rate characteristics are associated with abnormal neuroimaging and outcomes in extremely low birth weight infants. Fairchild KD, Sinkin RA, Davalian F, Blackman AE, Swanson JR, Matsumoto JA, Lake DE, Moorman JR, Blackman JA. J Perinatol. (2014) Feb 20. doi: 10.1038/jp.2014.18.

Infection and Other Clinical Correlates of Abnormal Heart Rate Characteristics in Preterm Infants. Sullivan BA, Grice SM, Lake DE, Moorman JR, Fairchild KD. J Pediatr. (2014) Jan 9.

Depressed Heart Rate Variability is Associated with Abnormal EEG, MRI, and Death in Neonates with Hypoxic Ischemic Encephalopathy. Vergales BD, Zanelli SA, Matsumoto JA, Goodkin HP, Lake DE, Moorman JR, Fairchild KD. Am J Perinatol. (2013) Dec 17.

Heart rate characteristics in the NICU: what nurses need to know. Hicks JH, Fairchild KD. J Adv Neonatal Care. (2013) Dec;13(6):396-401. doi: 10.1097/ANC.0000000000000031.

HeRO monitoring in the NICU: sepsis detection and beyond. Hicks JH, Fairchild KD. Infant. (2013) 9(6):187-191.

Experiences with the HeRO System for the Past Ten Years. Maxwell SR. Neonatology Today. (2013) Oct; 8(10):11-12.

Septicemia mortality reduction in neonates in a heart rate characteristics monitoring trial. Fairchild KD, Schelonka RL, Kaufman DA, Carlo WA, Kattwinkel J, Porcelli PJ, Navarrete CT, Bancalari E, Aschner JL, Walker MW, Perez JA, Palmer C, Lake DE, O’Shea TM, Moorman JR. Pediatr Res. (2013) Aug 13. doi: 10.1038/pr.2013.136.

Abnormal heart rate characteristics before clinical diagnosis of necrotizing enterocolitis. Stone ML, Tatum PM, Weitkamp JH, Mukherjee AB, Attridge J, McGahren ED, Rodgers BM, Lake DE, Moorman JR, Fairchild KD. J Perinatol. (2013) May 30.

Predictive monitoring for early detection of sepsis in neonatal ICU patients. Fairchild KD. Curr Opin Pediatr (2013) Apr;25(2):172-9.

HeRO monitoring to reduce mortality in NICU patients. Fairchild KD, Aschner JL. P Research and Reports in Neonatology (2012) Aug 14.

Cytokine Screening identifies NICU patients with Gram-negative bacteremia. Raynor LL, Saucerman JJ, Akinola MO, Lake DE, Moorman, JR, Fairchild KD. Pediatrics Res (2012) Mar; 71(3):261-6.

Future Directions in the Evaluation and Management of Neonatal Sepsis Bhatti M, Chu A, Hageman JR, Schreiber M, Alexandar K. NeoReviews (2012) Feb; 13(2):e103-e110.

Mortality Reduction by Heart Rate Characteristic Monitoring in Very Low Birth Weight Neonates: A Randomized Trial Moorman, JR, Carlo WA, Kattwinkel J, Schelonka RL, Porcelli PJ, Navarrete CT, Bancalari E, Aschner JL, Walker MW, Perez JA, Palmer C, Stukenborg GJ, Lake DE, O’Shea TM. J Pediatrics (2011) Dec; 159(6):900-6.

Cardiovascular oscillations at the bedside: early diagnosis of neonatal sepsis using heart rate characteristics monitoring. Moorman JR, Delos JB, Flower AA, Cao H, Kovatchev BP, Richman JS, Lake DE. Physiol Meas. 2011 Nov;32(11):1821-32. doi: 10.1088/0967-3334/32/11/S08. Epub 2011 Oct 25.

Pathogen-induced heart rate changes associated with cholinergic nervous system activation. Fairchild KD, Srinivasan V, Moorman JR, Gaykema RP, Goehler LE. Am J Physiol Regul Integr Comp Physiol (2011) Feb;300(2):R330-9.

Heart Rate Characteristics: Physiomarkers for Detection of Late-Onset Neonatal Sepsis Fairchild KD, O’Shea TM. Clin Perinatol 37 (2010) 581-598.

Periodic heart rate decelerations in premature infants Flower AA, Moorman JR, Lake DE, Delos JB. Exp Bio Med (Maywood) 2010 Apr;235(4):531-8.

Endotoxin depresses heart rate variability in mice: cytokine and steroid effects. Fairchild KD, Saucerman JJ, Raynor LL, Sivak JA, Xiao Y, Lake DE, Moorman JR. Am J Physiol Regul Integr Comp Physiol (2009) Oct; 297(4):R1019-27.

Heart rate characteristics and neurodevelopmental outcome in very low birth weight infants Addison K, Griffin MP, Moorman JR, Lake DE, O’Shea TM. Journal of Perinatology 2009 Jun 25;doi:10.1038/jp.2009.81.

Nearest-Neighbor and Logistic Regression Analyses of Clinical and Heart Rate Characteristics in the Early Diagnosis of Neonatal Sepsis. Xiao Y, Griffin P, Lake DE, Moorman JR. Medical Decision Making 2009 Jun 18;doi:10.1177/0272989X09337791.

Heart rate characteristics and clinical signs in neonatal sepsis. Griffin MP, Lake DE, O’Shea TM, Moorman JR. Pediatr Res 2007 Feb;61(2):222-7.

Heart rate characteristics monitoring for neonatal sepsis. Moorman JR, Griffin MP, Lake DE. IEEE Trans Biomed Eng 2006 Jan; 53(1): 126-132.

Heart rate characteristics: novel physiomarkers to predict neonatal infection and death. Griffin MP, Lake DE, Bissonette EA, Harrell FE, O’Shea TM, Moorman JR. Pediatrics 2005;116:1070-1074.

Heart rate characteristics and laboratory tests in the diagnosis of neonatal sepsis. Griffin MP, Lake DE, Moorman JR. Pediatrics 2005;115:937-941.

Abnormal heart rate characteristics are associated with neonatal mortality. Griffin MP, O’Shea TM, Bissonette EA, Harrell FE, Lake DE, Moorman JR. Pediatr Res 2004;55:782-788.

Sample entropy analysis. Richman JS, Lake DE, Moorman JR. Methods Enzymol 2004;384:172-84.

Sample asymmetry analysis of heart rate characteristics with application to neonatal sepsis and systemic inflammatory response syndrome. Kovatchev BP, Farhy LS, Cao H, Griffin MP, Lake DE, Moorman JR. Pediatr Res 2003;54:892-8.

Abnormal heart rate characteristics preceding neonatal sepsis and sepsis-like illness. Griffin MP, O’Shea TM, Bissonette EA, Harrell FE, Lake DE, Moorman JR. Pediatr Res 2003;53:920-926.

Sample entropy analysis of neonatal heart rate variability. Lake DE, Richman JS, Griffin MP, Moorman JR. Am J Physiol Regul Integr Comp Physiol 2002;283:R789-797.

Comparison and clinical application of frequency domain methods in analysis of neonatal heart rate time series. Chang KL, Monahan KJ, Griffin MP, Lake DE, Moorman JR. Ann Biomed Eng 2001;29:764-774.

Physiological time series analysis using approximate entropy and sample entropy. Richman JS, Moorman JR. Am J Physiol Heart Circ Physiol 2000;278:H2039-2049.

Probing the order in neonatal heart rate variability. Nelson JC, Rizwan-uddin, Griffin MP, Moorman JR. Pediatr Res 1998;43:823-831.

Scaling and ordering of neonatal heart rate variability. Aghili AA, Rizwan-uddin, Griffin MP, Moorman JR. Phys Rev Lett 1995;74:1254-1257.

The dynamic range of neonatal heart rate variability. Griffin MP, Scollan DF, Moorman JR. J Cardiovasc Electrophysiol 1994;5:112-124.