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(Chest. 1994;106:1711-1716.)
© 1994 American College of Chest Physicians

Heart Rate Variability During Sleep in Infants With Bronchopulmonary Dysplasia

Effects of Mild Decrease in Oxygen Saturation

Slavi I. Filtchev MD, PhD1; Lilia Curzi-Dascalova MD, PhD1; Lubomir Spassov MD, PhD1; François Kauffmann PhD2; Ha T. T. Trang MD, PhD1; and Claude Gaultier MD, PhD1

1 From INSERM CJF 89-09, Laboratoire de Physiologie, Hôpital Antoine Béclère, Clamart, France
2 From Faculté de Mathematiques, Université de Caen, Caen, France

We sought to determine whether abnormal heart rate modulation by the autonomic nervous system occurs in patients with severe bronchopulmonary dysplasia (BPD) in relation to sleep stages and mild changes in arterial oxygen saturation SaO2. On 10 oxygen-dependent 7-to 29-month-old infants with BPD, polygraphic recordings, including heart and respiratory rate and body movement detection, were performed. Heart rate variability was evaluated in high (HF), mid, and low (LF) frequency bands. Parameters were analyzed in two ranges of SaO2: normal range, (SaO2 greater than 95%), and mild decrease in (SaO2, values of 90 to 94%). In contrast to what is normally observed, LF at normal SaO2 was less marked in rapid eye movement, (REM) sleep than in non-rapid eye movement (NREM) sleep stage 2. A mild decrease in SaO2, as compared with a normal SaO2 value, was associated with: (1) a heart and respiratory rate acceleration, (2) a decrease in HF in REM sleep (p<0.02); (3) an increase in LF in NREM sleep stage 2 (p<0.02), intensifying the change observed in a normal SaO2 level. These data show that a mild decrease in SaO2 increases modifications of autonomic control observed in infants with severe BPD.

Key Words: bronchopulmonary dysplasia • heart rate • hypoxia • infants • movements • respiration • sleep

Submitted on September 21, 1993
Accepted on May 17, 1994




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