van Ravenswaaij-Arts C M, Hopman J C, Kollée L A, Stoelinga G B, van Geijn H P
Department of Paediatrics, University Hospital, Nijmegen, The Netherlands.
Pediatr Res. 1995 Jan;37(1):124-30. doi: 10.1203/00006450-199501000-00023.
To study the influence of artificial ventilation rate on neonatal heart rate variability (HRV), ECG and respiratory impedance curves were recorded four times a day in 20 preterm infants (< 33 wk) during the first 3 d after birth while the infants were ventilated at a wide range of ventilator rates. The contents of selected frequency bands within the R-R interval power spectrum were calculated for 3-min periods. Respiratory distress syndrome severity was assessed at each measurement. Respiratory sinus arrhythmia (RSA) induced by the ventilator appeared to mimic spontaneous RSA. As in spontaneous respiration, the amount of RSA (power in a frequency band around the respiratory rate) increases as the ventilation rate decreases. This phenomenon is most probably due to entrainment with baroreflex-related fluctuations in the heart rate. Although the artificial ventilation rate influences RSA and thus high-frequency HRV, an increase in respiratory distress syndrome severity results in a decrease in low-frequency HRV. Thus, the attenuation of low-frequency HRV by respiratory distress syndrome is not likely to be due to artificial ventilation.
为研究人工通气频率对新生儿心率变异性（HRV）的影响，在出生后前3天，对20名早产儿（<33周）每天记录4次心电图（ECG）和呼吸阻抗曲线，同时以广泛的通气频率对婴儿进行通气。计算RR间期功率谱内选定频段的内容，每次测量持续3分钟。每次测量时评估呼吸窘迫综合征的严重程度。呼吸机诱发的呼吸性窦性心律失常（RSA）似乎模拟了自发性RSA。与自主呼吸一样，随着通气频率降低，RSA的量（呼吸频率附近频段的功率）增加。这种现象很可能是由于与压力反射相关的心率波动的夹带。尽管人工通气频率会影响RSA，进而影响高频HRV，但呼吸窘迫综合征严重程度的增加会导致低频HRV降低。因此，呼吸窘迫综合征导致的低频HRV衰减不太可能是由于人工通气。
