Emergence of physiological rhythmicity in term and preterm neonates in a neonatal intensive care unit.
Emergence of physiological rhythmicity in term and preterm neonates in a neonatal intensive care unit.
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DOI：
10.1186/1740-3391-4-11
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发表时间：
2006-09-11
影响因子：
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通讯作者：
Komada, Yoshihiro
中科院分区：
文献类型：
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作者：
Begum, Esmot ara;Bonno, Motoki;Komada, Yoshihiro
背景：生物节律，特别是昼夜节律，被认为是维持生理功能的关键机制。然而，人们对新生儿重症监护病房 (NICU) 早产儿和足月新生儿的生物节律模式知之甚少。在这项研究中，我们调查了NICU收治的足月和早产新生儿在新生儿期是否表现出生物节律性。方法：对出生后0-21天内入住NICU的187名新生儿进行24小时连续记录4个生理变量（心率：心电图记录的HR；脉率：脉搏血氧仪记录的PR；呼吸频率：RR；脉搏血氧仪的血氧饱和度：SpO2）。 （PNA）。通过频谱分析（SPSS程序Spectra）来分析节律性。进行 Fisher 检验以检验周期的统计显着性。具有周期图强度最大峰值的周期被确定为主周期并通过傅立叶分析确认。计算每个主导周期的振幅和振幅指数。结果：在PNA 0-3天内，23.8％的新生儿在HR中观察到昼夜节律周期，20％在PR中观察到，27.8％在RR中观察到，16％在SpO2中观察到昼夜节律周期。 PR 中 PNA 3 天内，昼夜节律周期百分比在胎龄 (GA) < 28 周时最高 (40%)，并随着 GA 的增加而降低，在 PNA 3 天内，在 > 或 = 37 周 GA 时最低 (14.3%)，并在后期 PNA 中降低。在 PR 中观察到 GA 幅度的增加，并且在所有时期都存在显着的组间差异。 PR 中振幅和振幅指数与受孕后年龄 (PCA) 呈正相关 (p < 0.001)。在临床参数中，吸氧与出生后 3 天的 PR 昼夜节律显着相关（p < 0.05）。 结论：新生儿的昼夜节律可能是由母亲影响造成的，而 PCA 中 PR 振幅指数的增加可能与生理成熟度有关。需要进一步的研究来阐明氧合对新生儿生理节律的影响。
BACKGROUND: Biological rhythmicity, particularly circadian rhythmicity, is considered to be a key mechanism in the maintenance of physiological function. Very little is known, however, about biological rhythmicity pattern in preterm and term neonates in neonatal intensive care units (NICU). In this study, we investigated whether term and preterm neonates admitted to NICU exhibit biological rhythmicity during the neonatal period.METHODS: Twenty-four-hour continuous recording of four physiological variables (heart rate: HR recorded by electrocardiogram; pulse rate: PR recorded by pulse oxymetry; respiratory rate: RR; and oxygen saturation of pulse oxymetry: SpO2) was conducted on 187 neonates in NICU during 0-21 days of postnatal age (PNA). Rhythmicity was analyzed by spectral analysis (SPSS procedure Spectra). The Fisher test was performed to test the statistical significance of the cycles. The cycle with the largest peak of the periodogram intensities was determined as dominant cycle and confirmed by Fourier analysis. The amplitudes and amplitude indexes for each dominant cycle were calculated.RESULTS: Circadian cycles were observed among 23.8% neonates in HR, 20% in PR, 27.8% in RR and 16% in SpO2 in 0-3 days of PNA. Percentages of circadian cycles were the highest (40%) at < 28 wks of gestational age (GA), decreasing with GA, and the lowest (14.3%) at > or = 37 wks GA within 3 days of PNA in PR and were decreased in the later PNA. An increase of the amplitude with GA was observed in PR, and significant group differences were present in all periods. Amplitudes and amplitude indexes were positively correlated with postconceptional age (PCA) in PR (p < 0.001). Among clinical parameters, oxygen administration showed significant association (p < 0.05) with circadian rhythms of PR in the first 3 days of life.CONCLUSION: Whereas circadian rhythmicity in neonates may result from maternal influence, the increase of amplitude indexes in PR with PCA may be related to physiological maturity. Further studies are needed to elucidate the effect of oxygenation on physiological rhythmicity in neonates.