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How to score arousals in preterm infants?

Wie sollen Arousals bei Frühgeborenen untersucht werden? Kann man die Arousal Definition des „Pediatric Wake-up Club” auch bei Frühgeborenen anwenden?

Can we use recommendations of the pediatric wake-up club?

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Zusammenfassung

Arousals treten im Schlaf auf und reflektieren im Kindesalter eine Aktivierung verschiedener Hirnstamm- und Kortexstrukturen und verändern sich typischerweise mit dem Lebensalter. Ziel der Studie war es herauszufinden, ob die Arousal Definition des „Pediatric Wake-up Club” auch für Frühgeborene angewendet werden kann.

Eine Polysomnographie wurde bei 7 stabilen Frühgeborenen mit einem mittleren Gestationsalter von 34,4±1,2 Wochen durchgeführt. Insgesamt wurden 52 Arousals entsprechend den Empfehlungen des „Pediatric Wake-up Club” (Brüssel 2002) analysiert. Relevante Parameter wurden während eines Arousals sowie 30 Sekunden vor und nach einem Arousal analysiert. Die 30-Sekunden-Perioden vor und nach einem Arousal wurden zwecks einer detailierteren Datenanalyse noch in 10-Sekunden-Abschnitte unterteilt.

Die mittlere Dauer von Arousals betrug 7±3 Sekunden. Die Atemfrequenz war während eines Arousals höher (35±15 bpm) verglichen mit der Periode vorher (29±14 bpm; p<0,01) und nachher (29±11 bpm; p<0,001). Die Herzfrequenz war während eines Arousals niedriger (131±30 bpm) verglichen mit der 10-Sekunden-Periode vorher (140±14 bpm; p<0,05).

Die Arousal Definition des „Pediatric Wake-up Club” eignet sich sehr gut für die Untersuchung von Arousals bei Frühgeborenen.

Summary

Infants’ arousals from sleep reflect the activation of various brain stem and cortical structures and their characteristics change with age. Arousal scoring based on the Pediatric Wake-up Club definition of arousal in infants was evaluated to determine whether arousals could be reliably identified and assessed in preterm infants also.

Polygraphic recordings were made in seven stable preterm infants with a mean postconceptional age of 34.4±1.2 weeks. Fifty-two arousals were scored according to the guidelines of the Pediatric Wake-up Club (Consensus meeting in Brussels, 2002). Values of interest were assessed during the arousal period and during the 30-second periods before and after the arousal. The latter periods were subdivided into 10-second intervals and compared with the arousal period.

The mean duration of arousal was 7±3 seconds. Respiratory rate was higher (35±15 bpm) during the arousal than in the periods preceding (29±14 bpm; p<0.01) and following (29±11 bpm; p<0.001) it. Heart rate decreased during the arousal (131±30 bpm) when compared with the preceding 10-second period (140±14 bpm; p<0.05).

We found that arousals in preterm infants can be reliably identified and assessed using the Pediatric Wakeup Club’s arousal definition for term infants.

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Authors and Affiliations

  1. Department of Pediatries, University of Graz, Auenbruggerplatz 30, A-8036, Graz, Austria

    Heinz Zotter, Berndt Urlesberger, Wilhelm Müller & Reinhold Kerbl

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  1. Heinz Zotter
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  2. Berndt Urlesberger
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  3. Wilhelm Müller
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  4. Reinhold Kerbl
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Correspondence to Heinz Zotter.

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Zotter, H., Urlesberger, B., Müller, W. et al. How to score arousals in preterm infants?. Wien Klin Wochenschr 115, 867–870 (2003). https://doi.org/10.1007/BF03040407

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