Autonomic cardiovascular control in hypotensive critically ill preterm infants is impaired during the first days of life

Vera Golder, Joanne Michelle Hepponstall, Stephanie Yiallourou, Alexsandria Odoi, Rosemary Sylvia Claire Horne

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Abstract

The first days after preterm birth are a critical period of cardiovascular instability, where hypotension is common. We assessed autonomic cardiovascular function by measuring heart rate variability (HRV), blood pressure variability (BPV) and baroreflex sensitivity (BRS) and hypothesised that these would be impaired in preterm infants born at younger gestational ages. In addition, we speculated that impaired cardiovascular control could be used as a marker of circulatory failure such as is manifest as hypotension. METHODS: 23 preterm infants (11 M/12 F) born between 23 and 35 weeks (mean 27 +/- 0.6 weeks) gestational age with indwelling arterial catheters were recruited. Infants were studied over the first 3 days of life with heart rate and blood pressure (BP) analysed beat to beat in the frequency domain in 2 minute epochs of artefact free data during active sleep. Data were compared with one way ANOVA. RESULTS: Gestational age was correlated with all HRV indices but not BPV or BRS. 9 babies received inotropes. Gestational age between the inotrope group and the non-inotrope group was not different. BP and RR interval were lower in the inotrope group (40.7 +/- 1.5 vs 47.1 +/- 1.5 mmHg, p
Original languageEnglish
Pages (from-to)419 - 423
Number of pages5
JournalEarly Human Development
Volume89
Issue number6
DOIs
Publication statusPublished - 2013

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