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Altered cardiovascular control in preterm infants with bronchopulmonary dysplasia
Suvi Viskari1, Sture Andersson, Timo Hytinantti
1Hospital for Children and Adolescents, University of Helsinki, 00029 HUS, Finland.
Insights
Infants with bronchopulmonary dysplasia show impaired vestibular control of heart rate and blood pressure. This dysfunction may increase risks in hazardous situations, potentially linking to sudden infant death syndrome.
Area of Science:
- Neonatal physiology
- Cardiovascular regulation
- Vestibular system function
Background:
- Vestibular-mediated cardiovascular control is crucial for managing hazardous situations.
- Impaired vestibular control is hypothesized as a prerequisite for sudden infant death syndrome (SIDS).
- Prematurity and postnatal intermittent hypoxia are risk factors for SIDS.
Purpose of the Study:
- To investigate vestibulo-mediated cardiovascular control in infants with bronchopulmonary dysplasia (BPD).
- To compare cardiovascular responses to vestibular stimulation between BPD infants and healthy term infants.
Main Methods:
- Cardiovascular tests (heart rate and blood pressure) were conducted during slow-wave sleep under polysomnographic monitoring.
- Ten infants with BPD (born prematurely) and 20 healthy term infants (controls) participated.
- Stimuli included side motion and head-up tilts.
Main Results:
- Control infants exhibited biphasic heart rate and blood pressure responses to side motion.
- Half of the BPD infants displayed altered blood pressure responses, lacking an initial increase and showing a more pronounced decrease.
- BPD infants demonstrated significantly greater variability in blood pressure responses to head-up tilts compared to controls.
Conclusions:
- Some infants with BPD exhibit impaired vestibular sympathoreflex-mediated cardiovascular control.
- This cardiovascular dysfunction in BPD infants may pose critical risks during life-threatening events.
- Findings suggest a potential link between impaired vestibular cardiovascular control and SIDS risk in vulnerable infants.
Abstract:
Vestibulo-mediated cardiovascular control in hazardous situations is important. Our hypothesis is that the prerequisite for sudden infant death syndrome (SIDS) is impaired vestibulo-mediated cardiovascular control. Prematurity is a risk factor for SIDS, and postnatal intermittent hypoxia may contribute to this risk. We studied heart rate (HR) and blood pressure (BP) responses in 10 infants with bronchopulmonary dysplasia (BPD) who were born at 27 +/- 2.4 (23-30) wk of gestation. Twenty healthy term infants served as controls. Cardiovascular tests were performed under polysomnographic control during slow-wave sleep (SWS) at a corrected age of 12 +/- 3.5 (7-19) wk. Control infants showed biphasic HR and BP responses to side motion with an immediate increase followed by a modest decrease and return to baseline. Compared with the controls, half of the BPD infants had altered BP responses (p < 0.005) without an early increase, followed by a more prominent decrease in BP. BPD infants also presented with a greater variability in BP responses to head-up tilts than did the controls (p < 0.001). In conclusion, these findings suggest that some BPD infants have impaired vestibular sympathoreflex-mediated cardiovascular control. This dysfunction may become critical in life-threatening situations.
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