Detrended fluctuation analysis of blood pressure in preterm infants with intraventricular hemorrhage

Very preterm infants are at high risk of death and serious permanent brain damage, as occurs with intraventricular hemorrhage (IVH). Detrended fluctuation analysis (DFA) that quantifies the fractal correlation properties of physiological signals has been proposed as a potential method for clinical risk assessment. This study examined whether DFA of the arterial blood pressure (ABP) signal could derive markers for the identification of preterm infants who developed IVH. ABP data were recorded from a prospective cohort of 30 critically ill preterm infants in the first 1-3 h of life, 10 of which developed IVH. DFA was performed on the beat-to-beat sequences of mean arterial pressure (MAP), systolic blood pressure (SBP) and pulse interval, with short-term exponent (alpha (1), for timescale of 4-15 beats) and long-term exponent (alpha (2), for timescale of 15-50 beats) computed accordingly. The IVH infants were found to have higher short-term scaling exponents of both MAP and SBP (alpha (1) = 1.06 +/- A 0.18 and 0.98 +/- A 0.20) compared to the non-IVH infants (alpha (1) = 0.84 +/- A 0.25 and 0.78 +/- A 0.25, P = 0.017 and 0.038, respectively). The results have demonstrated that fractal dynamics embedded in the arterial pressure waveform could provide useful information that facilitates early identification of IVH in preterm infants.