Sepsis, a critical bacterial infection of the bloodstream, is a frequent cause of illness and death in premature infants in the neonatal intensive care units. A prospective analysis was conducted of the inter–beat-intervals time series (IBI) derived from 1 hour 30 minutes electrocardiogram (ECG) recordings for 14 episodes of clinical sepsis in 90 infants 12-18 hour old in the maternity ward of the Consorcio-Hospital General Universitario de Valencia. The aim was to test the hypothesis that normal beat-to-beat fluctuations in heart rate show fractal long-range correlations and that pathological condition reduce the adaptive capacity of the individual degrading the information carried by their signals and modifying the fractal scaling characteristics. Fractal properties of these series were evaluated by applying the method of Detrended Fluctuation Analysis (DFA) for the quantification of the correlation property in the highly non-stationary IBI time series. The main finding is that heart rate time series from infants with sepsis show a breakdown of the long-range correlation behaviour and consequently complexity-loss. The long-range scaling exponents for the sepsis cases showed a statistically significant deviation (p<0.001) from the long-range scaling exponents of the healthy cases. This method may be of use in distinguishing healthy from pathologic time series of infants with sepsis based on differences in the fractal scaling property, and could be introduced into the clinical practice for the assessment of heart rate patterns of new born infants.
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- Fractal Changes in the Long-Range Correlation and Loss of Signal Complexity in Infant’s Heart Rate Variability with Clinical Sepsis
C. García Vicent
E. F. Lurbe