School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW 2052, Australia.
Med Biol Eng Comput. 2013 Sep;51(9):1051-7. doi: 10.1007/s11517-013-1083-0. Epub 2013 May 29.
Very preterm infants are at high risk of death and serious permanent brain damage, as occurs with intraventricular hemorrhage (IVH). Detrended fluctuation analysis (DFA) that quantifies the fractal correlation properties of physiological signals has been proposed as a potential method for clinical risk assessment. This study examined whether DFA of the arterial blood pressure (ABP) signal could derive markers for the identification of preterm infants who developed IVH. ABP data were recorded from a prospective cohort of 30 critically ill preterm infants in the first 1-3 h of life, 10 of which developed IVH. DFA was performed on the beat-to-beat sequences of mean arterial pressure (MAP), systolic blood pressure (SBP) and pulse interval, with short-term exponent (α1, for timescale of 4-15 beats) and long-term exponent (α2, for timescale of 15-50 beats) computed accordingly. The IVH infants were found to have higher short-term scaling exponents of both MAP and SBP (α1 = 1.06 ± 0.18 and 0.98 ± 0.20) compared to the non-IVH infants (α1 = 0.84 ± 0.25 and 0.78 ± 0.25, P = 0.017 and 0.038, respectively). The results have demonstrated that fractal dynamics embedded in the arterial pressure waveform could provide useful information that facilitates early identification of IVH in preterm infants.
极早产儿死亡和严重永久性脑损伤的风险很高，这与脑室出血（IVH）有关。去趋势波动分析（DFA）量化了生理信号的分形相关特性，已被提议作为一种潜在的临床风险评估方法。本研究探讨了动脉血压（ABP）信号的 DFA 是否可以得出用于识别发生 IVH 的早产儿的标志物。从前瞻性队列中记录了 30 名危重新生儿在生命的前 1-3 小时内的 ABP 数据，其中 10 名发生了 IVH。对平均动脉压（MAP）、收缩压（SBP）和脉搏间隔的逐拍序列进行了 DFA，相应地计算了短期指数（α1，用于 4-15 拍的时间尺度）和长期指数（α2，用于 15-50 拍的时间尺度）。结果发现，与非 IVH 婴儿相比，IVH 婴儿的 MAP 和 SBP 的短期标度指数（α1 = 1.06 ± 0.18 和 0.98 ± 0.20）更高（α1 = 0.84 ± 0.25 和 0.78 ± 0.25，P = 0.017 和 0.038，分别）。研究结果表明，嵌入动脉压力波形中的分形动力学可以提供有用的信息，有助于早期识别早产儿的 IVH。
