ArticleJournal of applied physiology (Bethesda, Md. : 1985)2012
Breath-by-breath analysis of cardiorespiratory interaction for quantifying developmental maturity in premature infants.
Article in Journal of applied physiology (Bethesda, Md. : 1985), 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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Who cites it
22 citing papers in PubMed.
- The origins of embodiment: behavioral and cardiovascular responses to music in very preterm newborns.Scientific reports · 2026Article
- Cardiorespiratory phase synchronization maturational trajectory: biomarker of autonomic nervous system development in preterm infants.Pediatric research · 2026Article
- Cardiorespiratory mechanisms triggered during music perception in preterm infants and adults.iScience · 2025Article
- Neonatal apnea and hypopnea prediction in infants with Robin sequence with neural additive models for time series.PLOS digital health · 2024Article
- Interictal respiratory variability predicts severity of hypoxemia after generalized convulsive seizures.Epilepsia · 2023Article
- Using Temporal Data Mining on Patient Data for Clinical Decision Making in the Care of the Sick Newborn.EC paediatrics : open access · 2022Article
- The principles of whole-hospital predictive analytics monitoring for clinical medicine originated in the neonatal ICU.NPJ digital medicine · 2022Review
- Vital signs as physiomarkers of neonatal sepsis.Pediatric research · 2022Review
- Signatures of illness in children requiring unplanned intubation in the pediatric intensive care unit: A retrospective cohort machine-learning study.Frontiers in pediatrics · 2022Article
- Benchmarking Transfer Entropy Methods for the Study of Linear and Nonlinear Cardio-Respiratory Interactions.Entropy (Basel, Switzerland) · 2021Article
- Cardiorespiratory coupling in preterm infants.Journal of applied physiology (Bethesda, Md. : 1985) · 2019Article
- Characterization of cardiorespiratory phase synchronization and directionality in late premature and full term infants.Physiological measurement · 2018Article
- Cardioventilatory Control in Preterm-born Children and the Risk of Obstructive Sleep Apnea.American journal of respiratory and critical care medicine · 2018Article
- Using Wavelet Entropy to Demonstrate how Mindfulness Practice Increases Coordination between Irregular Cerebral and Cardiac Activities.Journal of visualized experiments : JoVE · 2017Article
- Article
- Stochastic modeling of central apnea events in preterm infants.Physiological measurement · 2016Article
- Accurate automated apnea analysis in preterm infants.American journal of perinatology · 2014Article
- Article
- Predictive monitoring for early detection of sepsis in neonatal ICU patients.Current opinion in pediatrics · 2013Review
- Predictive monitoring for respiratory decompensation leading to urgent unplanned intubation in the neonatal intensive care unit.Pediatric research · 2013Article
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Authors and funding
11 authors.
Funding
Abstract
In healthy neonates, connections between the heart and lungs through brain stem chemosensory pathways and the autonomic nervous system result in cardiorespiratory synchronization. This interdependence between cardiac and respiratory dynamics can be difficult to measure because of intermittent signal quality in intensive care settings and variability of heart and breathing rates. We employed a phase-based measure suggested by Schäfer and coworkers (Schäfer C, Rosenblum MG, Kurths J, Abel HH. Nature 392: 239-240, 1998) to obtain a breath-by-breath analysis of cardiorespiratory interaction. This measure of cardiorespiratory interaction does not distinguish between cardiac control of respiration associated with cardioventilatory coupling and respiratory influences on the heart rate associated with respiratory sinus arrhythmia. We calculated, in sliding 4-min windows, the probability density of heartbeats as a function of the concurrent phase of the respiratory cycle. Probability density functions whose Shannon entropy had a <0.1% chance of occurring from random numbers were classified as exhibiting interaction. In this way, we analyzed 18 infant-years of data from 1,202 patients in the Neonatal Intensive Care Unit at University of Virginia. We found evidence of interaction in 3.3 patient-years of data (18%). Cardiorespiratory interaction increased several-fold with postnatal development, but, surprisingly, the rate of increase was not affected by gestational age at birth. We find evidence for moderate correspondence between this measure of cardiorespiratory interaction and cardioventilatory coupling and no evidence for respiratory sinus arrhythmia, leading to the need for further investigation of the underlying mechanism. Such continuous measures of physiological interaction may serve to gauge developmental maturity in neonatal intensive care patients and prove useful in decisions about incipient illness and about hospital discharge.
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