Holter Monitoring of Critically-ill Childern in PICU at Sohag University Hospital

Overview

Holter Monitoring is a way to continuously check the electrical activity of the heart . Continuous ECG recording show to be one of the most effective noninvasive clinical tools in the diagnosis of cardiac symptoms prognostic assessment and in the evaluation of many cardiac therapeutic intervention. The clinical utility of ambulatory ECG lies in its ability to examine continuously a patient over an extended period of time, permitting patient ambulatory activity and facilitating the diurnal electrocardiographic examination of a patient in a changing environmental conditions (both physical and psychological) .

Study Type

  • Study Type: Observational
  • Study Primary Completion Date: March 2023

Arms, Groups and Cohorts

  • critically-ill childern

Clinical Trial Outcome Measures

Primary Measures

  • Abnormalities detecred in Holter monitoring of critically-ill childern
    • Time Frame: one year
    • the relation between abnormalities detected in Holter and prognosis of critically-ill childern
  • The relation between heart rate variability and outcome ,prognosis of illness
    • Time Frame: one year
    • Increased illness severity and poor outcomes ,the most common method of objectively assesing autonomic nervous system dysregulation is through measurement of heart rate variability ,which reflect the normal ,physiologic alternation in the intervals in the time between consecutive heart beats that occur when there is balance of sympathetic and parasympathetic inputs on the electrical conduction system of the heart.
  • Arrhythmia detected in critically-ill childern
    • Time Frame: one year
    • arrhythmia detected in Holter of critically ill childern whom have any critical illness

Participating in This Clinical Trial

Inclusion Criteria

  • 1- children admitted to pediatric department as in : – Pediatric intensive care unit (PICU). – Pediatric critical care unit (PCCU). – Emergency room (ER). 2- Age from 1 month- 12 years. 3- Critical ill child fulfill these criteria: – Persistent convulsions. – Abnormal GCS – Haemodynamic instability – Foreign body inhalation – Sever cardiac problem – Irregular breathing – DKA – Others Exclusion Criteria:

1-Neonates 2-End-stage or those with end-organ failure . 3-Whom GCS is below 6. 4-Whom done cardiac catheterization for any purpose . 5-Previously done Holter. 6-Multiple traumatized patient.

Gender Eligibility: All

Minimum Age: 1 Month

Maximum Age: 12 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Sohag University
  • Provider of Information About this Clinical Study
    • Principal Investigator: Nourhan Ahmed Mohamed, resident doctor at pediateric department sohag university hospital – Sohag University

References

Kennedy HL. The history, science, and innovation of Holter technology. Ann Noninvasive Electrocardiol. 2006 Jan;11(1):85-94. doi: 10.1111/j.1542-474X.2006.00067.x.

Marsillio LE, Manghi T, Carroll MS, Balmert LC, Wainwright MS. Heart rate variability as a marker of recovery from critical illness in children. PLoS One. 2019 May 17;14(5):e0215930. doi: 10.1371/journal.pone.0215930. eCollection 2019.

Leteurtre S, Duhamel A, Salleron J, Grandbastien B, Lacroix J, Leclerc F; Groupe Francophone de Reanimation et d'Urgences Pediatriques (GFRUP). PELOD-2: an update of the PEdiatric logistic organ dysfunction score. Crit Care Med. 2013 Jul;41(7):1761-73. doi: 10.1097/CCM.0b013e31828a2bbd.

Rijnbeek PR, Witsenburg M, Schrama E, Hess J, Kors JA. New normal limits for the paediatric electrocardiogram. Eur Heart J. 2001 Apr;22(8):702-11. doi: 10.1053/euhj.2000.2399.

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