Model-Based Analysis of Apnea-Bradycardia events in Newborns

In preterm infants, recurrent episodes of apnea, bradycardia and severe intermittent hypoxia are mainly related to cardiorespiratory immaturity. These episodes are associated with major risks during the first weeks of life. Cardiorespiratory data consisting of a continuous 12 hours recording of transthoracic impedance and ECG signals were acquired in 18 preterm neonates. 106 isolated apnea events (>10 sec) were manually annotated from the database, of which 19 apneas with bradycardia. A system-level physiological model of cardio-respiratory interactions in the newborn is proposed and used to reproduce simulations of mixed apneas with and without bradycardia, by modifying the functional residual capacity. A first qualitative comparison between the simulations and the clinical data shows a close match between the experimental and simulated heart rate series during apnea with bradycardia (RMSE 4.96 bpm) and without (RMSE 2.02 bpm).