Influences on heart rate variability in spontaneously breathing preterm infants.

To investigate the influence of maturational and physiological factors on heart rate variability in spontaneously breathing very preterm infants (n = 29) a multiparametric study was performed during the first 3 days of life in infants born at a gestational age below 33 weeks. Four times a day, RR-intervals, respiration curve and rate, transcutaneously measured blood gases and observed body movements were recorded while the infants were asleep. All data were stored simultaneously in a micro-computer. Non-invasively measured blood pressure and patency of the ductus arteriosus were documented as well. Four sets of short- (STV) and long term variability (LTV) indices were calculated. Both STV and LTV appeared to be significantly influenced by conceptional and postnatal age in the appropriate for gestational age infants. LTV was influenced by the behavioural state and body movements. During state coincidence 2 ('active sleep') LTV was influenced by respiratory rate and the variations in transcutaneous PO2. An effect of blood pressure or ductus patency could not be demonstrated.

[1]  M. Rother,et al.  Cardiac aliasing--a possible cause for the misinterpretation of cardiorespirographic data in neonates. , 1989, Early human development.

[2]  J. Hopman,et al.  Doppler flow characteristics in the main pulmonary artery and the $$\overline {LA} /Ao$$ ratio before and after ductal closure in healthy newborns/Ao ratio before and after ductal closure in healthy newborns , 2006, Pediatric Cardiology.

[3]  E H Hon,et al.  Fetal heart rate variability: an approach to automated assessment. , 1979, American journal of obstetrics and gynecology.

[4]  H. Bucher,et al.  Transcutaneous carbon dioxide tension in newborn infants: reliability and safety of continuous 24-hour measurement at 42 degrees C. , 1986, Pediatrics.

[5]  D. Giddens,et al.  Breath Amplitude Modulation of Heart Rate Variability in Normal Full Term Neonates , 1986, Pediatric Research.

[6]  H. Prechtl,et al.  Are there behavioural states in the human fetus? , 1982, Early human development.

[7]  B. Sayers,et al.  Analysis of heart rate variability. , 1973, Ergonomics.

[8]  S. T. Nugent,et al.  Periodicities in respiration and heart rate in newborns. , 1983, Canadian journal of physiology and pharmacology.

[9]  C. V. van Ravenswaaij-Arts,et al.  The influence of physiological parameters on long term heart rate variability in healthy preterm infants , 1990, Journal of perinatal medicine.

[10]  J. Parer,et al.  Validity of mathematical methods of quantitating fetal heart rate variability. , 1985, American journal of obstetrics and gynecology.

[11]  T Wheeler,et al.  PATTERNS OF FETAL HEART RATE DURING NORMAL PREGNANCY , 1978, British journal of obstetrics and gynaecology.

[12]  H W Jongsma,et al.  Analysis of heart rate and beat-to-beat variability: Interval difference index. , 1980, American journal of obstetrics and gynecology.

[13]  B D Fletcher,et al.  The Lung and its Disorders in the Newborn Infant , 1965, Major problems in clinical pediatrics.

[14]  P. Johnson,et al.  A comparison of episodic heart‐rate patterns in the fetus and newborn , 1982, British journal of obstetrics and gynaecology.

[15]  B. McClure,et al.  STUDY OF HEART RATE VARIABILITY IN SICK NEWBORN INFANTS , 1980, Acta paediatrica Scandinavica.

[16]  E H Hon,et al.  Quantification of Fetal Heart Beat-to-Beat Interval Differences , 1973, Obstetrics and gynecology.

[17]  R I Kitney,et al.  Neonatal heart rate variability and its relation to respiration. , 1985, Journal of theoretical biology.

[18]  C R Brinkman,et al.  Development of neurohumoral control of fetal, neonatal, and adult cardiovascular functions. , 1977, American journal of obstetrics and gynecology.

[19]  J. M. Swartjes,et al.  Coincidence of behavioural state parameters in the human fetus at three gestational ages. , 1990, Early human development.

[20]  G. Cassady,et al.  Transcutaneous monitoring in the newborn infant. , 1983, The Journal of pediatrics.

[21]  F. Kotlarek,et al.  Microprocessor-based long term cardiorespirography. II. Status evaluation in term and premature newborns , 1983, Journal of perinatal medicine.

[22]  R. Cohen,et al.  Hemodynamic regulation: investigation by spectral analysis. , 1985, The American journal of physiology.

[23]  Factors Affecting Heart Rate Variability in Preterm Infants , 1980 .

[24]  R. A. Epstein,et al.  Relation of Beat-to-Beat Variability to Heart Rate in Normal Sleeping Infants , 1980, Pediatric Research.

[25]  M. K. Park,et al.  Accuracy of blood pressure measurement by the Dinamap monitor in infants and children. , 1987, Pediatrics.

[26]  R. Mellins,et al.  Determination of Sleep State in Infants Using Respiratory Variability , 1987, Pediatric Research.

[27]  B. Siassi,et al.  Cardiac and Respiratory Activity in Relation to Gestation and Sleep States in Newborn Infants , 1979, Pediatric Research.

[28]  A. C. Burton,et al.  RECOMMENDATIONS for human blood pressure determinations by sphygmomanometers. , 1967, Journal of the American Medical Association.

[29]  H W Jongsma,et al.  Heart rate as an indicator of the behavioral state. Studies in the newborn infant and prospects for fetal heart rate monitoring. , 1980, American journal of obstetrics and gynecology.

[30]  D. Lübbers,et al.  Reliability of transcutaneous monitoring of arterial Po2 in newborn infants , 1974, Archives of disease in childhood.

[31]  M K Hathorn,et al.  Analysis of periodic changes in ventilation in new‐born infants. , 1978, The Journal of physiology.

[32]  M. J. Maisels,et al.  Indirect BP Monitoring in the Newborn: Evaluation of a New Oscillometer and Comparison of Upper- and Lower-Limb Measurements , 1984 .

[33]  R E Kronauer,et al.  Oscillatory breathing patterns leading to apneic spells in infants. , 1982, Journal of applied physiology: respiratory, environmental and exercise physiology.

[34]  S L Nielsen,et al.  Heart rate response to breathing: dependency upon breathing pattern. , 1987, Clinical physiology.

[35]  D. Arduini,et al.  The development of fetal behavioural states: A longitudinal study , 1986, Prenatal diagnosis.

[36]  I Välimäki,et al.  Interaction of Heart Rate and Respiration in Newborn Babies , 1988, Pediatric Research.

[37]  G. J. Kloosterman.  On Intrauterine Growth , 1970 .