Related Experiment Videos
Abnormal heart rate tracings and serum creatine phosphokinase in addicted neonates
E M Ostrea1, P Kresbach, D K Knapp
1Department of Pediatrics, Hutzel Hospital, Detroit, MI.
Insights
Infants of drug-dependent mothers show abnormal heart rate patterns and elevated creatine phosphokinase (CPK) levels, indicating potential neurological effects of neonatal drug withdrawal. These cardiorespiratory changes persist despite clinical improvement.
Area of Science:
- Neonatal physiology
- Developmental pediatrics
- Pharmacology
Background:
- Neonatal drug withdrawal is a significant concern.
- Cardiorespiratory abnormalities can occur in affected infants.
- Limited data exists on specific heart rate patterns and biochemical markers.
Purpose of the Study:
- To investigate cardiorespiratory patterns in infants of drug-dependent mothers (IDDM).
- To compare heart rate variability and patterns between IDDM and normal infants.
- To assess serum creatine phosphokinase (CPK) levels in IDDM.
Main Methods:
- Continuous cardiorespirographic (CRG) monitoring for five postnatal days.
- Comparison of heart rate parameters (baseline, beat-to-beat, long-term variability) between IDDM and control groups.
- Measurement of serum CPK levels and analysis of CPK fractions.
Main Results:
- IDDM infants exhibited significantly higher baseline heart rate, beat-to-beat variability, and long-term variability compared to controls.
- Distinctive "wave-like" heart rate patterns (40 bpm fluctuations) were observed in IDDM.
- Elevated serum CPK levels (mean 984 IU/l) were found in IDDM, with 89% being the MM fraction. Tremors and hypertonicity were also noted.
Conclusions:
- Infants of drug-dependent mothers display abnormal heart rate patterns and elevated CPK, suggesting neurological and physiological disturbances.
- These cardiorespiratory changes persist even after clinical improvement from withdrawal symptoms.
- CRG monitoring and CPK levels may serve as indicators of neonatal drug withdrawal severity and impact.
Abstract:
Continuous cardiorespirographic (CRG) monitoring was done during the first five postnatal days in 12 infants of drug dependent mothers (IDDM) and 19 normal infants (control). Abnormal heart rate patterns in the IDDM included: (1) significantly (p less than 0.01) higher baseline heart rate (129 +/- 15 vs. 118 +/- 8), beat-to-beat variability (4.4 +/- 2.4 vs. 2.6 +/- 1.6) and long-term variability (15.5 +/- 6.6 vs. 7.0 +/- 3.9), as compared to control and (2) frequent and spontaneous occurrences of large (40 beats per minute), brief rise and fall in heart rate giving a striking "wave-like" appearance to the tracing. These changes were more intense in the IDDM with moderate to severe, as compared to mild withdrawal. Treatment of the infant's withdrawal with drugs resulted in a clinical improvement, but the abnormal heart rate tracings persisted. Serum creatine phosphokinase (CPK) was also elevated (greater than 450 IU/l) in the IDDM (mean +/- SE = 984 +/- 299 IU/l) and 89% of the total CPK was the MM fraction. These infants exhibited tremors and hypertonicity.