Surface electromyography for analysis of heart rate variability in preterm infants

Jost, Kerstin; Scherer, Sebastian; Angelis, Chiara De; Buchler, Marcel; Datta, Alexandre N.; Cattin, Philippe C.; Frey, Urs; Suki, Bélâ; Schulzke, Sven

doi:10.1088/1361-6579/aa996a

Cited by 6 publications

(7 citation statements)

References 27 publications

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“…These perturbations can lead to a destabilizing effect on breathing and therefore tracking movement can be an important marker for predicting apnea, which, if minimized, leads to neurodevelopmental benefits [12] , [41] , [42] . Further applications of monitoring gross body movement include its use in filtering heart rate variability and as a physiological marker to study growth and development in neonates [41] , [43] . Polysomnographic studies may also benefit from a ballistographic approach for monitoring movement, since visually identifying movement is not easy, as supported by the inter-rater agreement obtained in this study.…”

Section: Discussionmentioning

confidence: 99%

A Ballistographic Approach for Continuous and Non-Obtrusive Monitoring of Movement in Neonates

Joshi

Bierling

Long

et al. 2018

IEEE J. Transl. Eng. Health Med.

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Continuously monitoring body movement in preterm infants can have important clinical applications since changes in movement-patterns can be a significant marker for clinical deteriorations including the onset of sepsis, seizures, and apneas. This paper proposes a system and method to monitor body movement of preterm infants in a clinical environment using ballistography. The ballistographic signal (BSG) is acquired using a thin and a film-like sensor that is placed underneath an infant. Manual annotations based on video-recordings served as a reference standard for identifying movement. We investigated the performance of multiple features, constructed from the BSG waveform, to discriminate movement from no movement based on data acquired from 10 preterm infants. Since routine cardiorespiratory monitoring is prone to movement artifacts, we also compared the application of these features on the simultaneously acquired cardiorespiratory waveforms, i.e., the electrocardiogram, the chest impedance, and the photoplethysmogram. The BSG-based-features consistently outperformed those based on the routinely acquired cardiorespiratory waveforms. The best performing BSG-based feature-the signal instability index-had a mean (standard deviation) effect size of 0.90 (0.06), as measured by the area under the receiver operating curve. The proposed system for monitoring body movement is robust to noise, non-obtrusive, and has high performance in clinical settings.

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Section: Discussionmentioning

confidence: 99%

A Ballistographic Approach for Continuous and Non-Obtrusive Monitoring of Movement in Neonates

Joshi

Bierling

Long

et al. 2018

IEEE J. Transl. Eng. Health Med.

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“…A limitation of our study is the lack of real-time analysis of HRF at the bedside, i.e., the current set-up would not (yet) allow clinicians to incorporate SampEn into their decision making in the NICU. However, as shown previously, 17 the data quality control procedure could potentially be fully automated and bring this set-up an important step closer to real-time analysis. Further, we only acquired data from five daily, standardized, 3-h recordings.…”

Section: Primary Outcomementioning

confidence: 90%

“…Thoracic surface electromyography (sEMG) measurements for acquisition of HRF data and synchronized video recordings for sleep staging were performed as reported in recent validation studies. [17][18][19] Briefly, daily sEMG measurements were conducted during the infant's first 5 days of life, starting at 8:30 a.m. and lasting for 3 h. Raw signal was captured at a sampling frequency of 500 Hz using commercially available software (Polybench, Inbiolab BV, Roden, NL). Time-synchronized video recordings of the infants were obtained at 15 Hz (LifeCam, Microsoft Corporation, Redmond, WA), and video-based sleep stages (awake, active sleep, quiet sleep) were scored at 10-s intervals as recommended 19,20 and as described previously.…”

Section: Measurementsmentioning

confidence: 99%

“…21 Extensive quality control of raw sEMG data was performed as described previously. 17 Raw data passing quality control were extracted for calculation of IBI using Matlab (The MathWorks, Inc., Natick, Massachusetts).…”

Section: Measurementsmentioning

confidence: 99%

“…38,39 As reported previously, we performed extensive data quality control in order to reduce the effect of motion artifacts on time series analysis and remove poor quality raw data. 17 In contrast to ScalExp, SampEn has been shown to be remarkably unaffected both analytically and experimentally by loss of up to 40% of raw data. 14 This might explain why only SampEn conferred prognostic utility in the current study.…”

Section: Interpretation and Significancementioning

confidence: 99%

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Heart rate fluctuation after birth predicts subsequent cardiorespiratory stability in preterm infants

et al. 2019

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BACKGROUND: Cardiorespiratory stability of preterm infants is a prerequisite for discharge from the neonatal intensive care unit (NICU) but very difficult to predict. We aimed to assess whether characterizing heart rate fluctuation (HRF) within the first days of life has prognostic utility. METHODS: We conducted a prospective cohort study in 90 preterm infants using a previously validated surface diaphragmatic electromyography (sEMG) method to derive interbeat intervals. We characterized HRF by time series parameters including sample entropy (SampEn) and scaling exponent alpha (ScalExp) obtained from daily 3-h measurements. Data were analyzed by multivariable, multilevel linear regression. RESULTS: We obtained acceptable raw data from 309/330 sEMG measurements in 76/90 infants born at a mean (range) of 30.2 (24.7-34.0) weeks gestation. We found a significant negative association of SampEn with duration of respiratory support (R 2 = 0.53, p < 0.001) and corrected age at discontinuation of caffeine therapy (R 2 = 0.35, p < 0.001) after adjusting for sex, gestational age, birth weight z-score, and sepsis. CONCLUSIONS: Baseline SampEn calculated over the first 5 days of life carries prognostic utility for an estimation of subsequent respiratory support and pre-discharge cardiorespiratory stability in preterm infants, both important for planning of treatment and utilization of health care resources.

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Caffeine preserves quiet sleep in preterm neonates

Koch

Schönfeld

Jost

et al. 2020

Pharmacology Res & Perspec

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Caffeine is widely used in preterm neonates suffering from apnea of prematurity (AOP), and it has become one of the most frequently prescribed medications in neonatal intensive care units. Goal of this study is to investigate how caffeine citrate treatment affects sleep‐wake behavior in preterm neonates. The observational study consists of 64 preterm neonates during their first 5 days of life with gestational age (GA) <32 weeks or very low birthweight of < 1500 g. A total of 52 patients treated with caffeine citrate and 12 patients without caffeine citrate were included. Sleep‐wake behavior was scored in three stages: active sleep, quiet sleep, and wakefulness. Individual caffeine concentration of every neonate was simulated with a pharmacokinetic model. In neonates with GA ≥ 28 weeks, wakefulness increased and active sleep decreased with increasing caffeine concentrations, whereas quiet sleep remained unchanged. In neonates with GA < 28 weeks, no clear caffeine effects on sleep‐wake behavior could be demonstrated. Caffeine increases fraction of wakefulness, alertness, and most probably also arousability at cost of active but not quiet sleep in preterm neonates. As such, caffeine should therefore not affect time for physical and cerebral regeneration during sleep in preterm neonates.

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Surface electromyography for analysis of heart rate variability in preterm infants

Abstract: Thoracic sEMG is a promising method to assess motion artifacts and calculate HRV in preterm neonates.

Cited by 6 publications

References 27 publications

A Ballistographic Approach for Continuous and Non-Obtrusive Monitoring of Movement in Neonates

A Ballistographic Approach for Continuous and Non-Obtrusive Monitoring of Movement in Neonates

Heart rate fluctuation after birth predicts subsequent cardiorespiratory stability in preterm infants

Caffeine preserves quiet sleep in preterm neonates

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