Zotter Heinz, Kerbl Reinhold, Reiterer Friedrich, Pichler Gerhard, Hanzer Marie, Mueller Wilhelm
Division of Neonatology, Department of Pediatrics, Medical University of Graz, Auenbruggerplatz 30, Graz, Austria.
Acta Paediatr. 2009 Jan;98(1):47-51. doi: 10.1111/j.1651-2227.2008.00995.x. Epub 2008 Aug 18.
To find out whether a correlation of heart rate (HR) and respiratory frequency (RF) defined as HR-RF-ratio (HRR) may be helpful to identify arousals in term and preterm infants.
Polygraphic recordings were performed in 25 term infants (gestational age 40.1 +/- 1.1 weeks) and 25 preterm infants (gestational age 31.1 +/- 1.3 weeks) during undisturbed daytime sleep. Arousals were scored as suggested by the 'International Paediatric Work Group on Arousals' and divided into cortical arousals and subcortical arousals. HRR was defined as HR over RF. Arousals were compared to a 30-sec period preceding an arousals.
Two hundred arousals were scored (100 cortical arousals and 100 subcortical arousals). HRR increased during arousals in term infants (p < 0.001). This was true for cortical arousals (p < 0.001) and subcortical arousals (p < 0.05) of term infants. In contrast, in preterm infants HRR remained unchanged during cortical arousals and subcortical arousals.
An increase of HRR during arousals is a simple parameter to identify arousals in term infants, but not in preterm infants suggesting that an unchanged HRR might be an indicator of an immature arousal response.
探究心率(HR)与呼吸频率(RF)的相关性(定义为HR-RF比值,即HRR)是否有助于识别足月儿和早产儿的觉醒。
对25名足月儿(胎龄40.1±1.1周)和25名早产儿(胎龄31.1±1.3周)在白天安静睡眠期间进行多导记录。按照“国际儿科学会觉醒工作组”的建议对觉醒进行评分,并分为皮层觉醒和皮层下觉醒。HRR定义为HR除以RF。将觉醒与觉醒前30秒的时间段进行比较。
共记录到200次觉醒(100次皮层觉醒和100次皮层下觉醒)。足月儿觉醒期间HRR升高(p<0.001)。足月儿的皮层觉醒(p<0.001)和皮层下觉醒(p<0.05)均如此。相比之下,早产儿在皮层觉醒和皮层下觉醒期间HRR保持不变。
觉醒期间HRR升高是识别足月儿觉醒的一个简单参数,但不适用于早产儿,这表明HRR不变可能是觉醒反应不成熟的一个指标。