An analysis of the respiratory dynamics of preterm infants

[摘要] ENGLISH ABSTRACT: Poor understanding of preterm infant physiology attributes to the high infant mortality rates, as well as its corresponding financial burden. Prematurity compromises the respiratory and regulatory systems of infants. This manifests itself in characteristic respiratory dynamics consisting of apneas, periodic breathing and regular breathing. These dynamics, if captured, quantified and visualised have potential to track maturational changes in infants. This can aid physicians in the difficult task of assessing a preterm infant's level of physiological maturity and offer insight into the infant's regulatory systems.The primary objective of this study was to develop a transition model representing the behaviour of and temporal relationship between the different respiratory states of preterm infants. Secondary objectives consisted of the following: Analysing 2 – 5 s cessations, their contribution to breathing cessation and relationship to apnea; temporally tracking the respiratory stability of preterm infants; and studying the relationship between breathing cessations and heart rate behaviour.Transition models were developed that adequately represented the respiratory dynamics of preterm infants. It showed that respiratory events are related in time, but that periodic breathing rarely precedes apnea of prematurity. On average 9% of breathing cessation and less than 1% of periodic breathing was found in the dataset. It was found that the contribution of short cessations were large, and that there is a temporal periodicity to the percentage cessations in the respiratory signal. Coupling between the respiratory and cardiac systems could be observed, with an apparent common temporal periodicity between some heart rate variability measures and percentage cessation in breathing signal.In conclusion, all objectives were successfully addressed and greater insight was gained into the physiology of preterm infants. Future value exists in applying these analyses on a larger, more longitudinal and clinically annotated dataset.

[发布机构] Stellenbosch University