Am J Perinatol. 2024 Oct 9. doi: 10.1055/a-2437-0461. Online ahead of print.
ABSTRACT
BACKGROUND: Much attention has been paid to measuring physiological episodes of bradycardia-oxygen desaturation (BDs) in the Neonatal Intensive Care Unit (NICU). NICU patients also have spells of tachycardia-desaturation (TD), but these have not been well characterized. We hypothesized that TDs would be more common among infants with bronchopulmonary dysplasia (BPD).
OBJECTIVES: We aimed to quantify daily TDs compared to BDs in NICU patients across a range of gestational and post-menstrual ages (GA, PMA) and to determine whether TDs are associated with BPD.
METHODS: We analyzed every-2-second heart rate (HR) and oxygen saturation (SpO2) throughout the NICU stay of all infants 24-39 weeks GA admitted to a single level IV NICU from 2012 to 2015. BDs were defined as in our prior work (HR <100 bpm for ≥ 4 seconds with concurrent SpO2 <80% for ≥10 seconds) and TDs as a 20% increase in HR from the previous 2-hour mean baseline and concurrent SpO2 <80% ≥10 seconds. We calculated the median daily BDs and TDs across a range of GA and PMA. For infants ≤32 weeks GA, we compared TDs for those with and without BPD at 36 weeks PMA and discharge on supplemental oxygen.
RESULTS: We analyzed 782,424 hours of HR and SpO2 data from 1718 infants, with a median of 271 hours analyzed per infant. TDs frequency increased with increasing PMA across all GAs. BDs occurred most frequently in infants <29 weeks GA and decreased as infants approached term equivalent age. For infants ≤32 weeks’ GA, one or more TD per day from 33-35w PMA was associated with BPD and home oxygen.
CONCLUSIONS: Episodes of TD at the thresholds defined in this analysis occurred more frequently at later PMA and were more common in infants with BPD and those requiring home oxygen.
PMID:39384297 | DOI:10.1055/a-2437-0461
