Deedee R Kommers1, Rohan Joshi2, Carola van Pul3, Louis Atallah4, Loe Feijs5, Guid Oei6, Sidarto Bambang Oetomo1, Peter Andriessen7. 1. Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands. 2. Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands; Department of Clinical Physics, Máxima Medical Center, Veldhoven, The Netherlands. Electronic address: r.joshi@tue.nl. 3. Department of Clinical Physics, Máxima Medical Center, Veldhoven, The Netherlands; Department of Applied Physics, Eindhoven University of Technology, Eindhoven, The Netherlands. 4. Patient Care and Measurements Department, Philips Research, Eindhoven, The Netherlands. 5. Department of Industrial Design, Eindhoven University of Technology, Eindhoven, The Netherlands. 6. Department of Gynecology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands. 7. Department of Neonatology, Máxima Medical Center, Veldhoven, The Netherlands; Department of Pediatrics, Maastricht University Medical Center, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
Abstract
OBJECTIVE: To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator. STUDY DESIGN: Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions. Eight HRV features (5 in the time domain and 3 in the frequency domain) were used to visually and statistically compare the pre-kangaroo care and during-kangaroo care periods. Two of these features, capturing the percentage of heart rate decelerations and the extent of heart rate decelerations, were newly developed for preterm infants. RESULTS: A total of 191 kangaroo care sessions were investigated in 11 preterm infants. Despite clinically irrelevant changes in vital signs, 6 of the 8 HRV features (SD of normal-to-normal intervals, root mean square of the SD, percentage of consecutive normal-to-normal intervals that differ by >50 ms, SD of heart rate decelerations, high-frequency power, and low-frequency/high-frequency ratio) showed a visible and statistically significant difference (P <.01) between stable periods of kangaroo care and pre-kangaroo care. HRV was reduced during kangaroo care owing to a decrease in the extent of transient heart rate decelerations. CONCLUSION: HRV-based features may be clinically useful for capturing the dynamic changes in autonomic regulation in response to kangaroo care and other changes in environment and state.
OBJECTIVE: To determine whether heart rate variability (HRV) can serve as a surrogate measure to track regulatory changes during kangaroo care, a period of parental coregulation distinct from regulation within the incubator. STUDY DESIGN: Nurses annotated the starting and ending times of kangaroo care for 3 months. The pre-kangaroo care, during-kangaroo care, and post-kangaroo care data were retrieved in infants with at least 10 accurately annotated kangaroo care sessions. Eight HRV features (5 in the time domain and 3 in the frequency domain) were used to visually and statistically compare the pre-kangaroo care and during-kangaroo care periods. Two of these features, capturing the percentage of heart rate decelerations and the extent of heart rate decelerations, were newly developed for preterm infants. RESULTS: A total of 191 kangaroo care sessions were investigated in 11 preterm infants. Despite clinically irrelevant changes in vital signs, 6 of the 8 HRV features (SD of normal-to-normal intervals, root mean square of the SD, percentage of consecutive normal-to-normal intervals that differ by >50 ms, SD of heart rate decelerations, high-frequency power, and low-frequency/high-frequency ratio) showed a visible and statistically significant difference (P <.01) between stable periods of kangaroo care and pre-kangaroo care. HRV was reduced during kangaroo care owing to a decrease in the extent of transient heart rate decelerations. CONCLUSION: HRV-based features may be clinically useful for capturing the dynamic changes in autonomic regulation in response to kangaroo care and other changes in environment and state.
Authors: Rohan Joshi; Zheng Peng; Xi Long; Loe Feijs; Peter Andriessen; Carola Van Pul Journal: IEEE J Transl Eng Health Med Date: 2019-11-22 Impact factor: 3.316