Kelsee L Shepherd1, Flora Y Wong1,2, Alexsandria Odoi1, Emma Yeomans2, Rosemary S C Horne1, Stephanie R Yiallourou3,4. 1. The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, VIC, Australia. 2. Monash Newborn, Monash Children's Hospital, Melbourne, VIC, Australia. 3. The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, VIC, Australia. stephanie.yiallourou@baker.edu.au. 4. Pre-Clinical Disease and Prevention, Baker Heart and Diabetes Institute and Central Clinical School, Monash University, Melbourne, VIC, Australia. stephanie.yiallourou@baker.edu.au.
Abstract
BACKGROUND: Prone sleeping is used in preterm infants undergoing intensive care to improve respiratory function, but evidence suggests that this position may compromise autonomic cardiovascular control. To test this hypothesis, this study assessed the effects of the prone sleeping position on cardiovascular control in preterm infants undergoing intensive care treatment during early postnatal life. METHODS: Fifty-six preterm infants, divided into extremely preterm (gestational age (GA) 24-28 weeks, n = 23) and very preterm (GA 29-34 weeks, n = 33) groups, were studied weekly for 3 weeks in prone and supine positions, during quiet and active sleep. Heart rate (HR) and non-invasive blood pressure (BP) were recorded and autonomic measures of HR variability (HRV), BP variability (BPV), and baroreflex sensitivity (BRS) using frequency analysis in low (LF) and high (HF) bands were assessed. RESULTS: During the first 3 weeks, prone sleeping increased HR, reduced BRS, and increased HF BPV compared to supine. LF and HF HRV were also lower prone compared to supine in very preterm infants. Extremely preterm infants had the lowest HRV and BRS measures, and the highest HF BPV. CONCLUSIONS: Prone sleeping dampens cardiovascular control in early postnatal life in preterm infants, having potential implications for BP regulation in infants undergoing intensive care.
BACKGROUND: Prone sleeping is used in preterm infants undergoing intensive care to improve respiratory function, but evidence suggests that this position may compromise autonomic cardiovascular control. To test this hypothesis, this study assessed the effects of the prone sleeping position on cardiovascular control in preterm infants undergoing intensive care treatment during early postnatal life. METHODS: Fifty-six preterm infants, divided into extremely preterm (gestational age (GA) 24-28 weeks, n = 23) and very preterm (GA 29-34 weeks, n = 33) groups, were studied weekly for 3 weeks in prone and supine positions, during quiet and active sleep. Heart rate (HR) and non-invasive blood pressure (BP) were recorded and autonomic measures of HR variability (HRV), BP variability (BPV), and baroreflex sensitivity (BRS) using frequency analysis in low (LF) and high (HF) bands were assessed. RESULTS: During the first 3 weeks, prone sleeping increased HR, reduced BRS, and increased HF BPV compared to supine. LF and HF HRV were also lower prone compared to supine in very preterm infants. Extremely preterm infants had the lowest HRV and BRS measures, and the highest HF BPV. CONCLUSIONS: Prone sleeping dampens cardiovascular control in early postnatal life in preterm infants, having potential implications for BP regulation in infants undergoing intensive care.
Authors: Stephanie R Yiallourou; Nicole B Witcombe; Scott A Sands; Adrian M Walker; Rosemary S C Horne Journal: Early Hum Dev Date: 2012-10-09 Impact factor: 2.079
Authors: Flora Y Wong; Nicole B Witcombe; Stephanie R Yiallourou; Sophie Yorkston; Alicia R Dymowski; Lalitha Krishnan; Adrian M Walker; Rosemary S C Horne Journal: Pediatrics Date: 2011-02-28 Impact factor: 7.124
Authors: Peter Andriessen; Rick L M Schoffelen; Ralph C M Berendsen; Nicole A M de Beer; S Guid Oei; Pieter F F Wijn; Carlos E Blanco Journal: Pediatr Res Date: 2003-11-19 Impact factor: 3.756
Authors: Flora Y Wong; Terence S Leung; Topun Austin; Malcolm Wilkinson; Judith H Meek; John S Wyatt; Adrian M Walker Journal: Pediatrics Date: 2008-02-04 Impact factor: 7.124