Abstract
Objectives
Much attention has been paid to measuring physiological episodes of bradycardia–oxygen
desaturation (BDs) in the neonatal intensive care unit (NICU). NICU patients also
have spells of tachycardia–desaturation (TDs), but these have not been well-characterized.
We hypothesized that TDs would be more common among infants with bronchopulmonary
dysplasia (BPD). We aimed to quantify daily TDs compared to BDs in NICU patients across
a range of gestational and postmenstrual ages (GA and PMA) and determine whether TDs
are associated with BPD.
Study Design
We analyzed every 2-second heart rate (HR) and peripheral saturation of oxygen (SpO2) throughout the NICU stay of all infants with 24 to 39 weeks GA admitted to a single,
level IV NICU from 2012 to 2015. BDs were defined in our prior work (HR <100 bpm for
≥4 seconds with concurrent SpO2 <80% for ≥10 seconds) and TDs as a 20% increase in HR from the previous 2-hour mean
baseline and concurrent SpO2 <80% for ≥10 seconds. We calculated the median daily BDs and TDs across a range of
GAs and PMAs. For infants ≤32 weeks GA, we compared TDs for those with and without
BPD at 36 weeks PMA and discharge on supplemental oxygen.
Results
We analyzed 782,424 hours of HR and SpO2 data from 1,718 neonates, with a median of 271 hours analyzed per infant. TDs frequency
increased with increasing PMA across all GAs. BDs occurred most frequently in infants
<29 weeks GA and decreased as infants approached term equivalent age. For infants
with ≤32 weeks GA, one or more TD per day from 33 to 35 weeks PMA was associated with
BPD and home oxygen.
Conclusion
Episodes of TD at the thresholds defined in this analysis occurred more frequently
at later PMA and were more common in infants with BPD and those requiring home oxygen.
Key Points
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Desaturation episodes occur often in preterm infants.
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Bradycardia or tachycardia can coincide with desaturation.
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TD occurs later and with BPD.
Keywords
neonates - desaturation - tachycardia - bronchopulmonary dysplasia
