Document Detail


Altered heart rhythm dynamics in very low birth weight infants with impending intraventricular hemorrhage.
MedLine Citation:
PMID:  19255007     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Intraventricular hemorrhage remains an important problem among very low birth weight infants and may result in long-term neurodevelopmental disabilities. Neonatologists have been unable to accurately predict impending intraventricular hemorrhage. Because alterations in the autonomic nervous system's control of heart rhythm have been associated with intraventricular hemorrhage after its development, we sought to determine if early subtle alterations of heart rhythm could be predictive of impending intraventricular hemorrhage in very low birth weight infants.
METHODS: This case-control study included 10 newborn very low birth weight infants with intraventricular hemorrhage (5 grade IV, 4 grade III, and 1 grade II) and 14 control infants without intraventricular hemorrhage. Heart rhythm data from the first day of life before the development of intraventricular hemorrhage were evaluated. Detrended fluctuation analysis, a nonlinear fractal heart rate variability method, was used to assess the fractal dynamics of the heart rhythm. Fractal scaling exponents were calculated by using this analysis.
RESULTS: Twenty-four infants (mean +/- SD, birth weight: 845 +/- 213g: gestational age: 26.1 +/- 1.9 weeks) participated in the study. The short-term scaling exponent was significantly larger in infants who later developed intraventricular hemorrhage compared with those who did not (0.60 +/- 0.1 vs 0.45 +/- 0.1). A value of 0.52 resulted in 70% sensitivity and positive predictive value and 79% specificity and negative predictive value. The short-term scaling exponent was the only significant predictor of intraventricular hemorrhage.
CONCLUSIONS: Fractal dynamics of the heart rhythm is significantly altered in very low birth weight infants before developing intraventricular hemorrhage and may be predictive of impending intraventricular hemorrhage.
Authors:
Volkan Tuzcu; Selman Nas; Umit Ulusar; Ahmet Ugur; Jeffrey R Kaiser
Related Documents :
333077 - Controlled trial of bicarbonate therapy in high-risk premature newborn infants.
9770157 - Comparative study of mortality and morbidity in premature infants (birth weight, < 1,25...
6873077 - The occipital horn of the lateral ventricles in premature infants. an ultrasonographic ...
6816037 - Choroid plexus hemorrhage in premature neonates: recognition by sonography.
9519127 - Early increases in ischaemic heart disease mortality dissociated from and later changes...
20453527 - Variability of end-expiratory lung volume in premature infants.
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatrics     Volume:  123     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2009 Mar 
Date Detail:
Created Date:  2009-03-03     Completed Date:  2009-03-30     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  810-5     Citation Subset:  AIM; IM    
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Autonomic Nervous System / physiopathology
Case-Control Studies
Cerebral Hemorrhage / diagnosis,  physiopathology*
Cerebral Ventricles
Early Diagnosis
Echoencephalography
Electrocardiography
Female
Fractals
Heart Rate / physiology*
Humans
Infant, Newborn
Infant, Premature, Diseases / diagnosis,  physiopathology*
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal
Male
Nonlinear Dynamics
Predictive Value of Tests
Probability
ROC Curve
Signal Processing, Computer-Assisted
Grant Support
ID/Acronym/Agency:
1 K23 NS43185/NS/NINDS NIH HHS; K23 NS043185/NS/NINDS NIH HHS; K23 NS043185-05/NS/NINDS NIH HHS; M01RR14288/RR/NCRR NIH HHS; R01 NS060674/NS/NINDS NIH HHS; R01 NS060674-01A1/NS/NINDS NIH HHS; R01 NS060674-05/NS/NINDS NIH HHS; RR20146/RR/NCRR NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Comparison of enrollment in interventional therapies between late-preterm and very preterm infants a...
Next Document:  Latent tuberculosis infection in children: a call for revised treatment guidelines.