Abstract
In preterm infants, a better understanding and quantification of cardiorespiratory coupling may help improve caregiving by enabling the tracking of maturational changes and subclinical signatures of disease. Therefore, in a study of 20 preterm infants admitted to a neonatal intensive care unit, we analyzed the cardiac and respiratory regulatory mechanisms as well as the coupling between them. In particular, we selectively analyzed coupling from changes in heart rate to respiratory oscillations as well as coupling from respiratory oscillations to the heart rate. Furthermore, we stratified this coupling based on decelerations and accelerations of the heart rate and by inspiration and expiration during respiration while contrasting periods of kangaroo care, an intervention known to enhance autonomic regulation, with periods in the incubator. We identified that preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling. We demonstrate coupling from decelerations and accelerations of the heart rate to exhalation and inhalation, respectively, both on a beat-to-beat basis as well as with sustained decelerations and accelerations. On the other hand, on average, we also observed coupling from both inspiration and expiration to marginal decelerations in the heart rate. These phenomena, especially coupling from the changes in the heart rate to respiratory oscillations, were sensitive to whether the infant was receiving kangaroo care. NEW & NOTEWORTHY Preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling; coupling from fluctuations in the heart rate to respiratory oscillations and vice versa are asymmetric. On average, coupling is observable from decelerations or accelerations in the heart rate to inhalation or exhalation, respectively, whereas, on average, both peaks and troughs of respiration exhibit coupling to marginal decelerations in the heart rate.
| Language | English |
|---|---|
| Pages | 202-213 |
| Number of pages | 12 |
| Journal | Journal of Applied Physiology |
| Volume | 126 |
| Issue number | 1 |
| DOIs | |
| State | Published - 1 Jan 2019 |
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Keywords
- autonomic regulation
- cardiorespiratory coupling
- kangaroo care
- preterm infants
- respiratory sinus arrhythmia
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Cardiorespiratory coupling in preterm infants. / Joshi, Rohan (Corresponding author); Kommers, Deedee (Corresponding author); Long, Xi; Feijs, Loe; van Huffel, Sabine; van Pul, Carola; Andriessen, Peter.
In: Journal of Applied Physiology, Vol. 126, No. 1, 01.01.2019, p. 202-213.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Cardiorespiratory coupling in preterm infants
AU - Joshi,Rohan
AU - Kommers,Deedee
AU - Long,Xi
AU - Feijs,Loe
AU - van Huffel,Sabine
AU - van Pul,Carola
AU - Andriessen,Peter
PY - 2019/1/1
Y1 - 2019/1/1
N2 - In preterm infants, a better understanding and quantification of cardiorespiratory coupling may help improve caregiving by enabling the tracking of maturational changes and subclinical signatures of disease. Therefore, in a study of 20 preterm infants admitted to a neonatal intensive care unit, we analyzed the cardiac and respiratory regulatory mechanisms as well as the coupling between them. In particular, we selectively analyzed coupling from changes in heart rate to respiratory oscillations as well as coupling from respiratory oscillations to the heart rate. Furthermore, we stratified this coupling based on decelerations and accelerations of the heart rate and by inspiration and expiration during respiration while contrasting periods of kangaroo care, an intervention known to enhance autonomic regulation, with periods in the incubator. We identified that preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling. We demonstrate coupling from decelerations and accelerations of the heart rate to exhalation and inhalation, respectively, both on a beat-to-beat basis as well as with sustained decelerations and accelerations. On the other hand, on average, we also observed coupling from both inspiration and expiration to marginal decelerations in the heart rate. These phenomena, especially coupling from the changes in the heart rate to respiratory oscillations, were sensitive to whether the infant was receiving kangaroo care. NEW & NOTEWORTHY Preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling; coupling from fluctuations in the heart rate to respiratory oscillations and vice versa are asymmetric. On average, coupling is observable from decelerations or accelerations in the heart rate to inhalation or exhalation, respectively, whereas, on average, both peaks and troughs of respiration exhibit coupling to marginal decelerations in the heart rate.
AB - In preterm infants, a better understanding and quantification of cardiorespiratory coupling may help improve caregiving by enabling the tracking of maturational changes and subclinical signatures of disease. Therefore, in a study of 20 preterm infants admitted to a neonatal intensive care unit, we analyzed the cardiac and respiratory regulatory mechanisms as well as the coupling between them. In particular, we selectively analyzed coupling from changes in heart rate to respiratory oscillations as well as coupling from respiratory oscillations to the heart rate. Furthermore, we stratified this coupling based on decelerations and accelerations of the heart rate and by inspiration and expiration during respiration while contrasting periods of kangaroo care, an intervention known to enhance autonomic regulation, with periods in the incubator. We identified that preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling. We demonstrate coupling from decelerations and accelerations of the heart rate to exhalation and inhalation, respectively, both on a beat-to-beat basis as well as with sustained decelerations and accelerations. On the other hand, on average, we also observed coupling from both inspiration and expiration to marginal decelerations in the heart rate. These phenomena, especially coupling from the changes in the heart rate to respiratory oscillations, were sensitive to whether the infant was receiving kangaroo care. NEW & NOTEWORTHY Preterm infants exhibit cardiorespiratory coupling that is nonsymmetric with regard to the direction of coupling; coupling from fluctuations in the heart rate to respiratory oscillations and vice versa are asymmetric. On average, coupling is observable from decelerations or accelerations in the heart rate to inhalation or exhalation, respectively, whereas, on average, both peaks and troughs of respiration exhibit coupling to marginal decelerations in the heart rate.
KW - autonomic regulation
KW - cardiorespiratory coupling
KW - kangaroo care
KW - preterm infants
KW - respiratory sinus arrhythmia
UR - http://www.scopus.com/inward/record.url?scp=85060799941&partnerID=8YFLogxK
U2 - 10.1152/japplphysiol.00722.2018
DO - 10.1152/japplphysiol.00722.2018
M3 - Article
VL - 126
SP - 202
EP - 213
JO - Journal of Applied Physiology
T2 - Journal of Applied Physiology
JF - Journal of Applied Physiology
SN - 8750-7587
IS - 1
ER -