Syracuse

Modeling Patient-specific Apnea-bradycardia Patterns in Preterm Newborn

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Duport, Orlane | Le Rolle, Virginie | Guerrero, Gustavo | Beuchée, Alain | Hernández, Alfredo, I.

Edité par CCSD ; Institute of Electrical and Electronics Engineers -

International audience. Objective: Preterm infants are particularly exposed to severe cardio-respiratory events, associating apnea with bradycardia and oxygen desaturation. A patient-specific and event-specific model-based approach is proposed in this work to analyze the acute heart rate response to apnea-bradycardia events in preterm newborn.Methods: A novel model integrating the main cardio-respiratory interactions which are specific to the neonatal period is proposed. An evolutionary algorithm is applied to estimate patient-specific model parameters from a database of 37 apnea-bradycardia episodes acquired from 10 preterm newborns. Unsupervised clustering (K-means) was applied to the identified parameters to define phenogroups of cardio-respiratory responses to apnea.Results: A significant correspondence was observed between simulated and experimental heart rate series in all identifications (median RMSE = 8.85 bpm). Three clusters of parameters were found and were associated to three different pathophysiological dynamics related to apnea-bradycardia.Conclusion and significance: The proposed method, based on patient and event-specific model parameter identification, provides a novel approach to characterize bradycardia dynamics in response to apnea, opening the way to the proposal of new personalized diagnosis and treatment possibilities in this particularly sensitive population.

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