V Peter Nagraj, Paige Howard, Karen D Fairchild, Brynne A Sullivan
{"title":"患有和未患有支气管肺发育不良的新生儿重症监护病房患者的心动过速-失饱和发作。","authors":"V Peter Nagraj, Paige Howard, Karen D Fairchild, Brynne A Sullivan","doi":"10.1055/a-2437-0461","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong> 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 (TDs), but these have not been well-characterized. We hypothesized that TDs would be more common among infants with bronchopulmonary dysplasia (BPD). We aimed to quantify daily TDs compared to BDs in NICU patients across a range of gestational and postmenstrual ages (GA and PMA) and determine whether TDs are associated with BPD.</p><p><strong>Study design: </strong> We analyzed every 2-second heart rate (HR) and peripheral saturation of oxygen (SpO<sub>2</sub>) throughout the NICU stay of all infants with 24 to 39 weeks GA admitted to a single, level IV NICU from 2012 to 2015. BDs were defined in our prior work (HR <100 bpm for ≥4 seconds with concurrent SpO<sub>2</sub> <80% for ≥10 seconds) and TDs as a 20% increase in HR from the previous 2-hour mean baseline and concurrent SpO<sub>2</sub> <80% for ≥10 seconds. We calculated the median daily BDs and TDs across a range of GAs and PMAs. For infants ≤32 weeks GA, we compared TDs for those with and without BPD at 36 weeks PMA and discharge on supplemental oxygen.</p><p><strong>Results: </strong> We analyzed 782,424 hours of HR and SpO<sub>2</sub> data from 1,718 neonates, 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 with ≤32 weeks GA, one or more TD per day from 33 to 35 weeks PMA was associated with BPD and home oxygen.</p><p><strong>Conclusion: </strong> 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.</p><p><strong>Key points: </strong>· Desaturation episodes occur often in preterm infants.. · Bradycardia or tachycardia can coincide with desaturation.. · TD occurs later and with BPD..</p>","PeriodicalId":7584,"journal":{"name":"American journal of perinatology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Tachycardia-Desaturation Episodes in Neonatal Intensive Care Unit Patients with and without Bronchopulmonary Dysplasia.\",\"authors\":\"V Peter Nagraj, Paige Howard, Karen D Fairchild, Brynne A Sullivan\",\"doi\":\"10.1055/a-2437-0461\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong> 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 (TDs), but these have not been well-characterized. We hypothesized that TDs would be more common among infants with bronchopulmonary dysplasia (BPD). We aimed to quantify daily TDs compared to BDs in NICU patients across a range of gestational and postmenstrual ages (GA and PMA) and determine whether TDs are associated with BPD.</p><p><strong>Study design: </strong> We analyzed every 2-second heart rate (HR) and peripheral saturation of oxygen (SpO<sub>2</sub>) throughout the NICU stay of all infants with 24 to 39 weeks GA admitted to a single, level IV NICU from 2012 to 2015. BDs were defined in our prior work (HR <100 bpm for ≥4 seconds with concurrent SpO<sub>2</sub> <80% for ≥10 seconds) and TDs as a 20% increase in HR from the previous 2-hour mean baseline and concurrent SpO<sub>2</sub> <80% for ≥10 seconds. We calculated the median daily BDs and TDs across a range of GAs and PMAs. For infants ≤32 weeks GA, we compared TDs for those with and without BPD at 36 weeks PMA and discharge on supplemental oxygen.</p><p><strong>Results: </strong> We analyzed 782,424 hours of HR and SpO<sub>2</sub> data from 1,718 neonates, 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 with ≤32 weeks GA, one or more TD per day from 33 to 35 weeks PMA was associated with BPD and home oxygen.</p><p><strong>Conclusion: </strong> 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.</p><p><strong>Key points: </strong>· Desaturation episodes occur often in preterm infants.. · Bradycardia or tachycardia can coincide with desaturation.. · TD occurs later and with BPD..</p>\",\"PeriodicalId\":7584,\"journal\":{\"name\":\"American journal of perinatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-11-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of perinatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-2437-0461\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of perinatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-2437-0461","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Tachycardia-Desaturation Episodes in Neonatal Intensive Care Unit Patients with and without Bronchopulmonary Dysplasia.
Objectives: 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 (TDs), but these have not been well-characterized. We hypothesized that TDs would be more common among infants with bronchopulmonary dysplasia (BPD). We aimed to quantify daily TDs compared to BDs in NICU patients across a range of gestational and postmenstrual ages (GA and PMA) and determine whether TDs are associated with BPD.
Study design: We analyzed every 2-second heart rate (HR) and peripheral saturation of oxygen (SpO2) throughout the NICU stay of all infants with 24 to 39 weeks GA admitted to a single, level IV NICU from 2012 to 2015. BDs were defined 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% for ≥10 seconds. We calculated the median daily BDs and TDs across a range of GAs and PMAs. 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 1,718 neonates, 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 with ≤32 weeks GA, one or more TD per day from 33 to 35 weeks PMA was associated with BPD and home oxygen.
Conclusion: 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.
Key points: · Desaturation episodes occur often in preterm infants.. · Bradycardia or tachycardia can coincide with desaturation.. · TD occurs later and with BPD..
期刊介绍：
The American Journal of Perinatology is an international, peer-reviewed, and indexed journal publishing 14 issues a year dealing with original research and topical reviews. It is the definitive forum for specialists in obstetrics, neonatology, perinatology, and maternal/fetal medicine, with emphasis on bridging the different fields.
The focus is primarily on clinical and translational research, clinical and technical advances in diagnosis, monitoring, and treatment as well as evidence-based reviews. Topics of interest include epidemiology, diagnosis, prevention, and management of maternal, fetal, and neonatal diseases. Manuscripts on new technology, NICU set-ups, and nursing topics are published to provide a broad survey of important issues in this field.
All articles undergo rigorous peer review, with web-based submission, expedited turn-around, and availability of electronic publication.
The American Journal of Perinatology is accompanied by AJP Reports - an Open Access journal for case reports in neonatology and maternal/fetal medicine.
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