Rhythms and complexity of respiration during sleep in pre-term infants.

The aim of this study is to test rhythmic and complex properties of respiratory control in former ventilated, pre-term infants during quiet and active sleep. The children had a higher risk for sudden infant death due to bronchopulmonary dysplasia (BPD). Twelve infants suffering from BPD and 12 control infants, matched regarding their post-conceptional age, were examined polygraphically during quiet (QS) and active sleep (AS). The respiratory rate (RR), the ratio (LF/HF) between the low-frequency power (LF) and the high-frequency power (HF) of the spectra of the thoracic respiratory effort, and the frequency of the dominant peak within LF (LFF) and HF (HFF) were computed. The correlation dimension (D2) of the respiratory signal was calculated to determine the complexity of the respiratory control. The transcutaneous pO2 (tcpO2) and pCO2 and the oxygen saturation (sO2) were analysed. Infants with BPD had significantly higher RR and HFF during QS (median: BPD 48 breaths min-1; control 32 breaths min-1). tcpO2 and sO2 were significantly lower in the BPD group. No differences were found in LF/HF, LFF or D2 between groups, either in QS or in AS. D2 ranged between 1.8 and 3.8, showing significantly higher values during AS. LFF was found to be lower during active sleep (AS 0.04-0.05 Hz; QS about 0.06 Hz). We propose that in infants with BPD the lower lung compliance and the higher resistance, and possibly also the hypoxaemia, contribute to the acceleration of breathing. The behaviour of RR, spectral parameters and D2 indicates a specific, functional setting rather than a regulatory impairment in infants with BPD.

[Continuous blood pressure monitoring during stress ECG]. / Kontinuierliche Blutdruckbestimmung während des Belastungs-EKG.

Using conventional methods (Riva-Rocci, oscillometric), non-invasive blood pressure measurements allow readings to be obtained only at discrete times, at intervals of at least one or two minutes. During exercise ECG recording, continuous blood pressure monitoring capable of detecting brief blood pressure changes is desirable. Our new approach is based on the known dependency of pulse wave velocity and blood pressure. The pulse transit time is derived from an ECG and a simultaneously recorded photoplethysmogram, and the blood pressure is computed using a linear model. In addition to the conventional ECG device, only a finger or ear sensor is required, so that the application of the method is quite easy. Results indicating dynamic blood pressure variations during an exercise ECG are presented.

Linear and nonlinear properties of heart rate control in infants at risk.

The aim of this study was to test whether the heart rate (HR) control in infants at risk differs in comparison with healthy infants. Twelve former preterm infants suffering from bronchopulmonary dysplasia and 18 control infants, matched for their postconceptional age, were examined polygraphically during quiet and active sleep. HR, low-frequency (LF) power, high-frequency (HF) power, total power, and the ratio of LF to HF power (LF/HF) of the instantaneous HR spectra were calculated for linear analysis. The largest Lyapunov exponent (LLE) of the R-R interval time series was calculated to determine a nonlinear property of HR. Infants at risk had significantly lower LF power (median: 0.51 x 10(-3) vs. 1.16 x 10(-3) Hz2) and lower LF/HF (median: 1.05 vs. 1.94) during quiet sleep. LLE was positive, revealing low-dimensional chaotic behavior of HR control, and did not differ between both groups (median: quiet sleep, 0.05 bit/s vs. 0.06 bit/s; active sleep, 0.16 bit/s vs. 0.15 bit/s). Sleep state-related changes in spectral parameters and LLE were similar in both groups. In infants at risk, the lower LF/HF during quiet sleep can be interpreted in terms of changes in the rhythmic components of the sympathovagal balance of the autonomic system, which is an expression of linear properties of HR control. Conversely, the lack of differences in LLE between both groups indicates similar nonlinear properties of the control system.

[Phonographic diagnostic aid in heart defects using neural networks]. / Phonographische Diagnosehilfe bei Herzfehlern unter Verwendung neuronaler Netze.

New approaches to pattern recognition and modeling using neural networks also provide powerful tools for the analysis of heart sounds in the diagnosis of heart failure. This paper describes how a neutral network can be used to estimate the duration of systolic and diastolic heart phases as well as to suggest a suitable diagnosis. A neural network-based auscultation system is capable of documenting and analysing a heart sound signal by applying methods similar to those used by physicians in the subjective interpretation of stethoscopic signals.