Abstract
Extremely preterm infants are at higher risk of pulmonary (PH) and intraventricular (IVH) haemorrhage during the transitioning physiology due to immature cardiovascular system. Monitoring of haemodynamics can detect early abnormal circulation that may lead to these complications. We described time-frequency relationships between near infrared spectroscopy (NIRS) cerebral regional haemoglobin oxygen saturation (CrSO2) and preductal peripheral perfusion index (PI), capillary oxygen saturation (SpO2) and heart rate (HR) in extremely preterm infants in the first 72 h of life. Patients were sub-grouped in infants with PH and/or IVH (NH = 8) and healthy controls (NC = 11). Data were decomposed in wavelets allowing the analysis of localized variations of power. This approach allowed to quantify the percentage of time of significant cross-correlation, semblance, gain (transfer function) and coherence between signals. Ultra-low frequencies (<0.28 mHz) were analyzed as slow and prolonged periods of impaired circulation are considered more detrimental than transient fluctuations. Cross-correlation between CrSO2 and oximetry (PI, SpO2 and HR) as well as in-phase semblance and gain between CrSO2 and HR were significantly lower while anti-phase semblance between CrSO2 and HR was significantly higher in PH-IVH infants compared to controls. These differences may reflect haemodynamic instability associated with cerebrovascular autoregulation and hemorrhagic complications observed during the transitioning physiology.
Highlights
Premature infants born
The percentages of anti-phase semblance, in-phase semblance and gain between CrSO2 and heart rate (HR) were not systematically kept significantly different between PH-IVH infants and controls. In this prospective observational study of 19 infants born
These relationships were described using wavelet decomposition that allowed deriving common time-frequency information between simultaneous recordings of CrSO2, preductal perfusion index (PI), SpO2 and HR. This is the first study in extremely premature infants reporting time-frequency analysis of simultaneous measurements of NIRS and preductal PI performed in the first 72 h of life
Summary
Premature infants born
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