Heart Rate Variability in Pediatric Patients with and without Sickle Cell Disease.

BACKGROUND: Pain management in sickle cell disease still suffers from gaps in its assessment and pathophysiology. Heart Rate Variability (HRV) can potentially provide information to assist in pain evaluation. Studies in adults and adolescents with Sickle Cell Disease (SCD) have shown that vaso-occlusive crises (VOCs) are associated with significant declines in HRV. OBJECTIVES: To assess feasibility of short-term HRV monitoring in children as young as two years old during routine outpatient visits and inpatient care.To compare baseline differences in HRV between patients with and without SCD as a reflection of underlying autonomic balance. METHODS: A commercially-available device was used to measure HRV non-invasively in patients with and without SCD. Participants aged 2 to 25 years were recruited as a convenience sample in a single institution. RESULTS: HRV signals can be analyzed from subjects as young as 2 years old with better quality of HRV signals in subjects age 10 years and up. Lower HRV was observed in patients with SCD compared to participants without SCD. CONCLUSION: HRV measurement is feasible in pediatric patients in different clinical settings using commercially available tools. The lower HRV observed in participants with SCD is consistent with altered autonomic regulation and increased sympathetic activity.