Bethesda, Md. -- Late gestation is a busy time for babies getting ready for life outside the womb, particularly for functions critical to life such as breathing and maintaining an adequate heartbeat. These two functions are connected in mature infants and healthy people throughout life, so measuring their level of connectedness can give doctors a cue about whether an infant is ready to head home or needs to remain in the care of the neonatal intensive care unit (NICU). Current methods to analyze this connection are not yet fully developed, leaving doctors and nurses without an optimal way to deal with periodically missing data or natural variations in breathing or heartbeat. Now, however, researchers in Virginia have found a way around this problem by using a new analytical method that looks for so-called cardiorespiratory interaction using individual breaths and heartbeats and relating the two in time. The findings shed light on which infants may be mature enough to leave the NICU, showing that postnatal age seems to be an indicator of maturity, but birth weight or gestational age at birth are not.
The article is entitled "Breath-By-Breath Analysis of Cardiorespiratory Interaction for Quantifying Developmental Maturity in Premature Infants." It appears in the current edition of the Journal of Applied Physiology, published by the American Physiological Society.
The researchers collected data from the bedside monitors of 1,202 infants cared for in the University of Virginia NICU from January 2009 to June 2011. This data included both electrocardiogram waveforms (an indicator of heartbeats) and chest impedance signals (an indicator of breaths) from both infants considered to have very low birth weights and those with normal birth weights. The researchers paired these two measures in sliding four minute windows, using software to determine whether patterns in breathing correlated with patterns in heartbeats. The
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American Physiological Society