aEEG, Hemodynamics & Body Composition

HeRO Score System

Continuous, ECG-derived HRC fold-risk score (MPSC) – quantifies pre-clinical signals of neonatal sepsis and deterioration; RCT-validated mortality reduction in VLBW neonates.

Late-onset sepsis remains a leading cause of mortality and morbidity in VLBW neonates, and the clinical signs are non-specific and late in the pathophysiological cascade.
The HeRO Score System detects pre-clinical changes in heart rate characteristics (HRC) – reduced variability and transient decelerations in the RR interval – that can be measurable hours to days before clinical presentation.
The HRC index is computed continuously from the existing bedside cardiac monitor signal, with no additional sensors, via a logistic-regression algorithm combining standard deviation, sample asymmetry, and sample entropy of the RR interval.
In a 3,003-patient NICHD multi-centre RCT, display of the HeRO score reduced all-cause mortality by more than 20%.

  • 24-hour predictive sepsis window – HRC fold-risk quantified for the ensuing 24 hours, enabling evaluation before haemodynamic compromise.
  • Beyond sepsis – Abnormal HRC has been associated with NEC, UTI, meningitis, respiratory decompensation, and brain pathology.
  • Mortality reduction in RCT – >20% reduction in all-cause mortality reported in the 3,003-patient NICHD trial.
  • Length-of-stay and cost outcomes – Reductions reported in published analyses.
  • No additional sensors or patient contact – analyses ECG already generated by existing bedside monitors.
  • Continuous automated scoring – single numerical fold-risk output.
  • Integrates into existing NICU monitoring workflow.

Used in VLBW and other high-risk NICU neonates for continuous surveillance of sepsis and clinical deterioration risk. Enables early identification of pre-clinical physiological change before vital-sign thresholds are breached.

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