Document Detail


Precursors of cardiorespiratory events in infants detected by home memory monitor.
MedLine Citation:
PMID:  18041078     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In 1,079 infants monitored for >700,000 hr at home for apnea or bradycardia, we found an association between infants having multiple events exceeding conventional or a priori defined more extreme thresholds and less favorable developmental outcome at 1 year of age than infants with few or no events. If it is necessary to prevent such events to minimize risk for developmental morbidity, there is reason to determine whether there are disturbances in advance of the apnea or bradycardia that herald their onset. In the 85 infants with at least 1 extreme event and 1 conventional event, we hypothesized that apnea and bradycardia do not occur de novo but rather are preceded by cardiorespiratory and hemoglobin O2 saturation changes. We compared recorded time intervals preceding these events, and we analyzed three preceding time intervals for each conventional and extreme event, and each non-event recording: Time-2 hr: up to 2 hr before; Time-1 hr: up to 1 hr before; and Time-75 sec: the 75 sec immediately preceding each event. O2 saturation progressively decreased preceding both conventional and extreme events, and progressive increases occurred in heart and breathing rate variability. Duration of respiratory pauses and of periodic breathing progressively increased preceding conventional events, respiratory rate variability increased immediately preceding conventional events and at 1 hr preceding extreme events, and O2 saturation decreased immediately preceding both conventional and extreme events. Thus, conventional and extreme events do not occur de novo but rather are preceded by autonomic instability of the cardiorespiratory system.
Authors:
Carl E Hunt; Michael J Corwin; George Lister; Debra E Weese-Mayer; Sally L Davidson Ward; Larry R Tinsley; Michael R Neuman; Marian Willinger; Rangasamy Ramanathan; Denis Rybin;
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric pulmonology     Volume:  43     ISSN:  8755-6863     ISO Abbreviation:  Pediatr. Pulmonol.     Publication Date:  2008 Jan 
Date Detail:
Created Date:  2007-12-06     Completed Date:  2008-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8510590     Medline TA:  Pediatr Pulmonol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  87-98     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2007 Wiley-Liss, Inc.
Affiliation:
Department of Pediatrics, University of Toledo Health Sciences Center, Toledo, Ohio 43699, USA. huntc@mail.nih.gov
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MeSH Terms
Descriptor/Qualifier:
Apnea / physiopathology*
Bradycardia / physiopathology*
Female
Gestational Age
Heart Rate
Humans
Infant, Newborn
Male
Monitoring, Ambulatory / methods*
Oximetry
Predictive Value of Tests
Respiration
Sudden Infant Death / prevention & control
Time Factors
Grant Support
ID/Acronym/Agency:
HD 20056/HD/NICHD NIH HHS; HD 28971/HD/NICHD NIH HHS; HD 29060/HD/NICHD NIH HHS; HD 29067/HD/NICHD NIH HHS; HD 29071/HD/NICHD NIH HHS; HD 29073/HD/NICHD NIH HHS; HD 34625/HD/NICHD NIH HHS

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


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