Bradycardias are associated with more severe effects on cerebral oxygenation in very preterm infants than in late preterm infants

Commonly the magnitude and frequency of bradycardia is underestimated in the neonatal unit due to the long averaging time used in bedside oximeters. We aimed to assess the frequency and severity of bradycardia in preterm infants using the lowest averaging time (2 s) available on a clinical oximeter,...

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Bibliographic Details
Published in:Early human development 2018-12, Vol.127, p.33-41
Main Authors: Walter, Lisa M., Ahmed, Bushra, Odoi, Alexsandria, Cooney, Hannah, Horne, Rosemary S.C., Wong, Flora Y.
Format: Article
Language:English
Subjects:
Cardiovascular
Neonatal
Oximetry
Tissue oxygenation index
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Summary:Commonly the magnitude and frequency of bradycardia is underestimated in the neonatal unit due to the long averaging time used in bedside oximeters. We aimed to assess the frequency and severity of bradycardia in preterm infants using the lowest averaging time (2 s) available on a clinical oximeter, compared with bradycardia detected using electrocardiogram (ECG), and whether bradycardia severity and postmenstrual age affected cerebral oxygenation. Preterm infants (10 M/9F) were studied longitudinally at 26–31 (very preterm) and 32–38 weeks (late preterm) postmenstrual age. Heart rate falls calculated from ECG were used to determine mild or moderate/severe (MS) bradycardias. Cerebral tissue oxygenation index (TOI, %) was recorded and fractional tissue oxygen extraction (FTOE) calculated. Of the 615 bradycardias scored using ECG criteria, 10% were not detected by oximetry. TOI falls associated with bradycardias were greater for MS bradycardias compared with Mild for both groups (p 
ISSN:0378-3782
1872-6232
DOI:10.1016/j.earlhumdev.2018.08.008