Gabai Nili, Cohen Ayala, Mahagney Ayed, Bader David, Tirosh Emanuel
The Hannah Khoushy Child Development Center, Bnai Zion Medical Center, Haifa, Israel.
Clin Physiol Funct Imaging. 2006 Mar;26(2):127-31. doi: 10.1111/j.1475-097X.2006.00661.x.
To investigate variations in the autonomic functions and blood-flow velocity of the arteries supplying to the brainstem in supine and prone positions.
Forty-one full-term infants were studied at the age of 24-72 h. Each infant underwent respiratory, cardiac and eye movement analyses in supine and prone positions. In addition, blood-flow velocity of the basilar and vertebral arteries was measured with a 2 MHz probe for 5 min in each position. Two time domain measures of heart rate variability (HRV) (Standard deviation of normal R-R intervals for long-term and pNN50 for short-term variability) were employed.
Significantly decreased short- (P<0.001) and long (P = 0.003)-term variabilities were observed in prone when compared with supine position. Increased short-term variability in active sleep with no interaction with position was observed (P = 0.005). A significant decreased mean (P = 0.001) and peak (P = 0.001-0.003) blood-flow velocity in prone when compared with supine position were measured in all three arteries supplying to the brainstem. No significant correlation between HRV and arterial blood-flow velocity (ABFV) was observed in either position.
The results of the present study in agreement with previous studies reflect the vulnerability of infants in prone position as related to brainstem function. However, it appears that ABFV and autonomic functions as reflected by HRV are independent physiological measures, possibly indicating regulation autonomy of the central nervous system.
研究仰卧位和俯卧位时脑干供血动脉的自主神经功能及血流速度变化。
对41名足月婴儿在24至72小时龄时进行研究。每名婴儿在仰卧位和俯卧位时均接受呼吸、心脏和眼动分析。此外,使用2兆赫探头在每个体位测量基底动脉和椎动脉的血流速度5分钟。采用两种心率变异性(HRV)时域测量指标(长期正常R-R间期标准差和短期变异性的pNN50)。
与仰卧位相比,俯卧位时短期(P<0.001)和长期(P = 0.003)变异性显著降低。观察到在主动睡眠时短期变异性增加,且与体位无交互作用(P = 0.005)。在供应脑干的所有三条动脉中,与仰卧位相比,俯卧位时平均血流速度(P = 0.001)和峰值血流速度(P = 0.001 - 0.003)显著降低。在任一位置,均未观察到HRV与动脉血流速度(ABFV)之间存在显著相关性。
本研究结果与先前研究一致,反映了俯卧位婴儿与脑干功能相关的脆弱性。然而,HRV所反映的ABFV和自主神经功能似乎是独立的生理指标,这可能表明中枢神经系统的调节自主性。