Cardiovascular Monitoring in Infants with Respiratory Distress Syndrome

Korvenranta, Heikki; Kero, Pentti; Välimäki, Ilkka

doi:10.1159/000241707

Cited by 19 publications

(7 citation statements)

References 9 publications

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“…In studies concerning the influence of RDS on HRV, it has been established that RDS predominantly attenuates LF HRV (2,6,7). This could be confirmed by our study.…”

Section: 208supporting

confidence: 90%

“…For each 3-min period, the mean R-R interval length was calculated. The severity of RDS was scored at each measurement series as class I (mild), I1 (moderate), or I11 (severe), according to Korvenranta et al (7). An overall RDS score was assigned to each infant based on the worst RDS score that was given at least three times (Table 1).…”

Section: Van Ravenswaaij-arts Et Almentioning

confidence: 99%

“…In newborns suffering from RDS, HRV appears to be attenuated (2,6,7). With improvement of the neonatal condition, HRV returns to normal (2).…”

mentioning

confidence: 97%

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The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

et al. 1995

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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. (Pediatr Res 37: 124-130, 1995) Abbreviations aRSA, artificial respiratory sinus arrhythmia aVR, artificial ventilation rate HF, high-frequency HRV, heart rate variability LF, low-frequency RDS, respiratory distress syndrome RSA, respiratory sinus arrhythmia VLF, very LF HRV, i.e. the variation in beat-to-beat R-R interval length, is influenced by maturational (e.g. gestational age), physiologic (e.g. respiration), and clinical factors (1, 2). HRV can be assessed by spectral analysis to study the frequency-specific oscillations in the heart rate signal. In the newborn, the following heart rate oscillations may be present. HF oscillations have a frequency equal to the respiratory rate and are known as RSA. LF oscillations are due to intrinsic oscillations of the baroreceptor reflex loop with a frequency of 0.07 Hz (3). A second kind of LF oscillation may result from periodic fluctuations in respiratory depth or tidal volume (4). The last type of HRV features VLF oscillations with a frequency below 0.04 Hz. These are ascribed to thermoregulation. H F oscillations are mediated by the parasympathetic system. LF and VLF oscillations are mediated by both the sympathetic and parasympathetic systems (5). Thus, studying neonatal HRV can give an insight into the maturation of the autonomic nervous system.In newborns suffering from RDS, HRV appears to be atten- HRV returns to normal (2). Several explanations have been proposed for this reversible effect of RDS on HRV. For instance, it has been ascribed to transient depression of the medulla oblongata by hypercarbia (2). The possible influence of artificial ventilation as such on neonatal HRV has not been taken into account in studies regarding the influence of RDS. For the correct interpretation of HRV in infants with RDS, insight into the effect of artificial ventilation on HRV is needed. This influence cannot be studied by simply comparing...

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“…In studies concerning the influence of RDS on HRV, it has been established that RDS predominantly attenuates LF HRV (2,6,7). This could be confirmed by our study.…”

Section: 208supporting

confidence: 90%

Section: Van Ravenswaaij-arts Et Almentioning

confidence: 99%

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The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

et al. 1995

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“…The severity of RDS was assessed by a clinical scoring system, as described earlier. 14 With this scoring system, RDS was graded as mild in 5, moderate in 27, and severe in 5 infants. All distressed infants received an infusion (10 mL/ kg) of Ringer's lactate solution (Ringersteril, Medipolar, Oulu, Finland) during the first 2 hours of life and were also infused with dopamine (5 fxg/kg/min) continuously during the first days of life.…”

Section: Methodsmentioning

confidence: 99%

Hemodynamic Control of Atrial Natriuretic Peptide Plasma Levels in Neonatal Respiratory Distress Syndrome

Kääpä¹,

Seppänen²,

Kero³

et al. 1995

Amer J Perinatol

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To evaluate the contribution of the pulmonary and ductal hemodynamics on the cardiac atrial natriuretic peptide (ANP) synthesis and release in neonatal respiratory distress syndrome, serial blood samples for plasma C-terminal end, and the more stable N-terminal end (NT-proANP) of the propeptide were obtained. Simultaneous evaluation of the systolic pulmonary artery pressure (PAP) and magnitude of ductal shunting by the Doppler method were made of 37 distressed infants during the first 4 days of life. Both plasma ANP and NT-proANP rose after birth, peaked at 48 hours of age, and correlated significantly (r = 0.66; p < 0.001; n = 78) with each other. The initially high systolic PAP and, since the systemic arterial pressure (SAP) did not change, the PAP/SAP ratio declined slowly during the study period, as did the magnitude of ductal left-to-right shunting after an initial increase during the first hours after birth. Plasma NT-proANP had a positive correlation to the magnitude of ductal left-to-right shunting both during the first 2 and 4 days of life, but did not correlate with PAP, SAP, or PAP/SAP ratio during the same time periods. Eight infants with delayed closure of the ductus maintained elevated plasma NT-proANP values after the second day of life.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…76,120,121 An association in infants with RDS between marked fluctuations in arterial blood pressure and fluctuating cerebral blood-flow velocity has been demonstrated; the association between this pattern and intraventricular hemorrhage (IVH) may be mediated as much by alterations on the venous side of the cerebral circulation as by alterations on the arterial side. 122,123 In a study in which a lower coefficient of variation of systolic blood pressure was observed, blood pressure fluctuation actually was lower in infants who developed IVH.…”

Section: Respiratory Supportmentioning

confidence: 99%

Definition of Normal Blood Pressure Range

Engle¹

2012

Hemodynamics and Cardiology: Neonatology Questions and Controversies

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Cardiovascular Monitoring in Infants with Respiratory Distress Syndrome

Cited by 19 publications

References 9 publications

The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

The Influence of Artificial Ventilation on Heart Rate Variability in Very Preterm Infants

Hemodynamic Control of Atrial Natriuretic Peptide Plasma Levels in Neonatal Respiratory Distress Syndrome

Definition of Normal Blood Pressure Range

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