title: [Autonomic regulation and bradycardia during the neonatal period].
abstract: The high frequency of bradycardia observed during the neonatal period requires cardiac monitoring but also understanding its intrinsic mechanisms, including responsiveness of the autonomic nervous system (ANS). Heart rate variability and spontaneous baroreflex analysis can help understand the autonomic dysregulation of cardiorespiratory control, possibly responsible for sudden infant death. In clinical neonatology practice, neonatal bradycardia does not warrant continuation of monitoring if it remains isolated, asymptomatic, and short (<10 s), followed by a rapid cardiac acceleration indicating an adapted sympathetic response. Further evaluation of ANS responsiveness is possible for newborns including analyzing the complexity of the heart rate and respiratory variability. This allows better targeting children with high risk after discharge. The real-time evaluation of autonomic regulation could become a valuable tool in clinical practice.
authors.affiliation: Réanimation néonatale et pédiatrique, centre hospitalier universitaire de Saint-Étienne, 42005 Saint-Étienne, France; EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France. Electronic address: hugues.patural@chu-st-etienne.fr.
authors.forename: H
authors.initials: H
authors.lastname: Patural
authors.affiliation: EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France.
authors.forename: S
authors.initials: S
authors.lastname: Flori
authors.affiliation: EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France.
authors.forename: V
authors.initials: V
authors.lastname: Pichot
authors.affiliation: EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France.
authors.forename: J-C
authors.initials: JC
authors.lastname: Barthelemy
authors.affiliation: EA SNA-Epis 4607, université Jean-Monnet, 42023 Saint-Étienne, France.
authors.forename: F
authors.initials: F
authors.lastname: Roche
mesh_terms: D000222:Adaptation, Physiological; D001341:Autonomic Nervous System / Q000503:physiopathology*; D017704:Baroreflex / Q000502:physiology; D001919:Bradycardia / Q000151:congenital* / Q000503:physiopathology*; D015716:Electrocardiography, Ambulatory; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007231:Infant, Newborn; D056152:Respiratory Rate / Q000502:physiology; D018570:Risk Assessment; D013398:Sudden Infant Death / Q000209:etiology; D013564:Sympathetic Nervous System / Q000503:physiopathology