HISTORY OF PRETERM INFANTS WITH HYPOXIC BRAIN DAMAGE

Abstract

Relevance. According to the experts of World Health Organization, diseases linked to perinatal hypoxic brain damage account for 70-80% of cases of childhood disability.
 This study aims to explore the historical records of heart rate and respiratory characteristics in preterm infants with hypoxic brain damage.
 Subjects and Methods. A prospective cohort study was conducted involving 160 preterm infants categorized into three groups: group I comprised conditionally healthy children, group II included children with hypoxic-ischemic central nervous system lesions, and group III involved children with hypoxic-hemorrhagic central nervous system lesions.
 Results. The analysis of heart rate parameters according to the data of daily monitoring of electrocardiogram has revealed a positive dynamic of reduction of heterotopic activity and a significant (p<0.05) improvement in the functional state of the conduction system of the heart in all preterm infants aged 20-30 months after a course of timely rehabilitation therapy of hypoxic brain damage. The presence of periodic breathing with respiratory pauses in preterm patients in the neonatal period was established, and a significantly longer duration of apnea was found in children with hypoxic-hemorrhagic central nervous system damage. There has been found an inverse correlation of moderate strength between gestational age and the amount of apnea during the day. Throughout the observation period, there was a gradual establishment of the sleep profile and its structural characteristics, indicating a physiological consolidation process marked by a regular alternation of stable rhythm phases. However, in newborns with hypoxic brain damage, autonomic dysregulation of heart rhythm persisted in the form of hypersympathicotonia. This suggests a high level of electrical instability of the myocardium, underscoring the necessity for ongoing clinical monitoring.