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Novel Uses of HeRO Respiratory deterioration is a major cause of spikes in HeRO Score [1] HeRO is an excellent predictor of need for intubation [2] HeRO predicts extubation success [3,4] Online calculators for extubation readiness and extubation success at: www.heroscore.com/extubation 1-Infection and Other Clinical Correlates of Abnormal Heart Rate Characteristics in Preterm Infants 2-Predictive monitoring for respiratory decompensation leading to urgent unplanned intubation in the neonatal intensive care unit 3-Predicting Extubation Outcomes—A Model Incorporating Heart Rate Characteristics Index 4-Predicting extubation outcomes using Heart Rate Characteristics Index in Preterm Infants: a cohort study.

HeRO User Reports Rio et al, in Switzerland, found “An increase of HRC index > 2 has a significant association with the diagnosis of [late onset sepsis (LOS)], supporting the use of HRC monitoring to assist early detection of LOS.” Kurul and colleagues, in the Netherlands, found that after implementing HeRO: Morbidity at the time of sepsis diagnosis was reduced “suggesting that patients were diagnosed earlier and less severely ill” Mortality after infection trended down (p=0.13) Antibiotic usage per 1000 NICU days trended down (p=0.06) There were more labs but no increase in blood cultures

Neurodevelopmental Outcomes were improved with HeRO Extremely low birthweight patients from the HeRO RCT had 18-22 month follow-up assessments at three study centers The in-NICU mortality improvement for HeRO-monitored patients was durable Among septic patients, rates of both death and death-or-NDI were decreased among HeRO-monitored patients Among non-septic patients, there were no differences in outcomes comparing HeRO-monitored patients with controls (indicating false positives had no impact on healthy patients)

Demonstrated that HeRO is cost effective and generates a positive Return On Investment to the hospital An economic analysis was performed using multiple study centers. It showed that HeRO was cost-effective for all rates of sepsis Although HeRO is a cost to the hospital, revenue was increased for additional patients who survived an infection Based upon US costs, the use of HeRO increased hospital revenue greater than the cost of HeRO itself