Cross-Correlation of Heart Rate and Oxygen Saturation in Very Low Birthweight Infants: Association with Apnea and Adverse Events

Overview

Journal Am J Perinatol

Specialty Gynecology & Obstetrics

Date 2017 Nov 16

PMID 29141263

Citations 20

Authors

Karen D Fairchild

Douglas E Lake

Affiliations

Soon will be listed here.

Abstract

Background: Analysis of subtle vital sign changes could facilitate earlier treatment of acute inflammatory illnesses. We previously showed that high cross-correlation of heart rate and oxygen saturation (XCorr-HR-SpO) occurs in some very low birthweight (VLBW) infants with sepsis, and hypothesized that this corresponds to apnea.

Methods: In 629 VLBW infants, we analyzed XCorr-HR-SpO in relation to central apnea with bradycardia and desaturation (ABD), BD with or without central apnea (BD), and percent time in periodic breathing (PB) throughout the neonatal intensive care unit (NICU) stay (75 infant-years). We reviewed 100 days with extremely high XCorr-HR-SpO (>0.7) and control days for clinical associations. Next, we identified all cases of late-onset septicemia (LOS) and necrotizing enterocolitis (NEC) and analyzed change in XCorr-HR-SpO before diagnosis.

Results: Mean XCorr-HR-SpO was ∼0.10, and increasing XCorr-HR-SpO was associated with increasing ABD, BD, and PB (correlation coefficients >0.93). Days with maximum XCorr-HR-SpO >0.7 were more likely to have an adverse event than control days (49% versus 13%). In 93 cases of LOS or NEC, there was a 67% increase in XCorr-HR-SpO in the 24-hour period prior to diagnosis compared with the previous day ( < 0.01).

Conclusion: High XCorr-HR-SpO is associated with apnea and adverse events including LOS and NEC.

Citing Articles

Noninvasive Tools to Predict Necrotizing Enterocolitis in Infants with Congenital Heart Diseases: A Narrative Review.

Moschino L, Guiducci S, Duci M, Meggiolaro L, Nardo D, Bonadies L Children (Basel). 2024; 11(11).

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Clinical correlates of a high cardiorespiratory risk score for very low birth weight infants.

Kausch S, Slevin C, Duncan A, Fairchild K, Lake D, Keim-Malpass J Pediatr Res. 2024; .

PMID: 39300276 DOI: 10.1038/s41390-024-03580-y.

Highly comparative time series analysis of oxygen saturation and heart rate to predict respiratory outcomes in extremely preterm infants.

Qiu J, Di Fiore J, Krishnamurthi N, Indic P, Carroll J, Claure N Physiol Meas. 2024; 45(5).

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Heart rate and oxygen saturation patterns in very low birth weight infants with early onset sepsis and histologic chorioamnionitis.

Bultmann C, Qiu J, Belmonte B, Fairchild K, Sullivan B J Neonatal Perinatal Med. 2024; 17(2):209-215.

PMID: 38578905 PMC: 11450634. DOI: 10.3233/NPM-230093.

Apnea, Intermittent Hypoxemia, and Bradycardia Events Predict Late-Onset Sepsis in Infants Born Extremely Preterm.

Kausch S, Lake D, Di Fiore J, Weese-Mayer D, Claure N, Ambalavanan N J Pediatr. 2024; 271:114042.

PMID: 38570031 PMC: 11239298. DOI: 10.1016/j.jpeds.2024.114042.

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