Nonstationary coupling between heart rate and perfusion index in extremely preterm infants in the first day of life

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dc.check.date2022-02-05
dc.check.infoAccess to this article is restricted until 12 months after publication by request of the publisher.en
dc.contributor.authorO'Toole, John M.
dc.contributor.authorDempsey, Eugene M.
dc.contributor.authorVan Laere, David
dc.contributor.funderScience Foundation Irelanden
dc.date.accessioned2021-02-22T10:24:15Z
dc.date.available2021-02-22T10:24:15Z
dc.date.issued2021-02-05
dc.date.updated2021-02-12T10:52:13Z
dc.description.abstractObjective: Adaptation to the extra-uterine environment presents many challenges for infants born less than 28 weeks of gestation. Quantitative analysis of readily-available physiological signals at the cotside could provide valuable information during this critical time. We aim to assess the time-varying coupling between heart rate (HR) and perfusion index (PI) over the first 24 hours after birth and relate this coupling to gestational age, inotropic therapy, and short-term clinical outcome. Approach: We develop new nonstationary measures of coupling to summarise both frequency- and direction-dependent coupling. These measures employ a coherence measure capable of measuring time-varying Granger casuality using a short-time information partial directed coherence function. Measures are correlated with gestational age, inotropic therapy (yes/no), and outcome (adverse/normal). Main Results: In a cohort of 99 extremely preterm infants (<28 weeks of gestation), we find weak but significant coupling in both the HR-to-PI and PI-to-HR directions (P<0.05). HR-to-PI coupling increases with maturation (correlation r=0.26; P=0.011); PI-to-HR coupling increases with inotrope administration (r=0.27; P=0.007). And nonstationary features of PI-to-HR coupling are associated with (r=0.27; P=0.009). Significance: Nonstationary features are necessary to distinguish different coupling types for complex biomedical systems. Time-varying directional coupling between PI and HR provides objective and independent biomarkers of adverse outcome in extremely preterm infants.en
dc.description.sponsorshipScience Foundation Ireland (15/SIRG/3580)en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationO'Toole, J. M., Dempsey, E. M. and Van Laere, D. (2021) 'Nonstationary coupling between heart rate and perfusion index in extremely preterm infants in the first day of life', Physiological Measurement. doi: 10.1088/1361-6579/abe3deen
dc.identifier.doi10.1088/1361-6579/abe3deen
dc.identifier.eissn1361-6579
dc.identifier.issn0967-3334
dc.identifier.journaltitlePhysiological Measurementen
dc.identifier.urihttps://hdl.handle.net/10468/11080
dc.language.isoenen
dc.publisherIOP Publishingen
dc.rights© 2021, Institute of Physics and Engineering in Medicine. As the Version of Record of this article is going to be/has been published on a subscription basis, this Accepted Manuscript will be available for reuse under a CC BY-NC-ND 3.0 licence after a 12 month embargo period.en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/3.0/en
dc.subjectNeonateen
dc.subjectPreterm infanten
dc.subjectHeart rateen
dc.subjectPerfusion indexen
dc.subjectCouplingen
dc.subjectGranger casualityen
dc.subjectNon-stationary connectivityen
dc.subjectInstantaneous frequencyen
dc.subjectCardiovascularen
dc.subjectInstabilityen
dc.titleNonstationary coupling between heart rate and perfusion index in extremely preterm infants in the first day of lifeen
dc.typeArticle (peer-reviewed)en
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