title: Characterizing Fluctuations of Arterial and Cerebral Tissue Oxygenation in Preterm Neonates by Means of Data Analysis Techniques for Nonlinear Dynamical Systems.
abstract: The cerebral autoregulatory state as well as fluctuations in arterial (SpO2) and cerebral tissue oxygen saturation (StO2) are potentially new relevant clinical parameters in preterm neonates. The aim of the present study was to test the investigative capabilities of data analysis techniques for nonlinear dynamical systems, looking at fluctuations and their interdependence. StO2, SpO2 and the heart rate (HR) were measured on four preterm neonates for several hours. The fractional tissue oxygenation extraction (FTOE) was calculated. To characterize the fluctuations in StO2, SpO2, FTOE and HR, two methods were employed: (1) phase-space modeling and application of the recurrence quantification analysis (RQA), and (2) maximum entropy spectral analysis (MESA). The correlation between StO2 and SpO2 as well as FTOE and HR was quantified by (1) nonparametric nonlinear regression based on the alternating conditional expectation (ACE) algorithm, and (2) the maximal information-based nonparametric exploration (MINE) technique. We found that (1) each neonate showed individual characteristics, (2) a ~60 min oscillation was observed in all of the signals, (3) the nonlinear correlation strength between StO2 and SpO2 as well as FTOE and HR was specific for each neonate and showed a high value for a neonate with a reduced health status, possibly indicating an impaired cerebral autoregulation. In conclusion, our data analysis framework enabled novel insights into the characteristics of hemodynamic and oxygenation changes in preterm infants. To the best of our knowledge, this is the first application of RQA, MESA, ACE and MINE to human StO2 data measured with near-infrared spectroscopy (NIRS).
authors.affiliation: Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
authors.forename: Stefan
authors.initials: S
authors.lastname: Kleiser
authors.affiliation: Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Pastewski
authors.affiliation: Department of Medical Physics and Bioengineering, University College London, London, UK.
authors.forename: Tharindi
authors.initials: T
authors.lastname: Hapuarachchi
authors.affiliation: Division of Neonatology, University of Zurich, 8091, Zurich, Switzerland.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Hagmann
authors.affiliation: Division of Neonatology, University of Zurich, 8091, Zurich, Switzerland.
authors.forename: Jean-Claude
authors.initials: JC
authors.lastname: Fauchère
authors.affiliation: Department of Medical Physics and Bioengineering, University College London, London, UK.
authors.forename: Ilias
authors.initials: I
authors.lastname: Tachtsidis
authors.affiliation: Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland.
authors.forename: Martin
authors.initials: M
authors.lastname: Wolf
authors.affiliation: Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091, Zurich, Switzerland. Felix.Scholkmann@usz.ch.
authors.forename: Felix
authors.initials: F
authors.lastname: Scholkmann
mesh_terms: D001158:Arteries / Q000378:metabolism; D001921:Brain / Q000378:metabolism*; D006339:Heart Rate; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D017711:Nonlinear Dynamics; D010100:Oxygen / Q000378:metabolism*; D013223:Statistics as Topic / Q000379:methods*
chemical_list: D010100:Oxygen
keywords: Autoregulation; Correlation analysis; Long term measurements; Near infrared spectroscopy; Spontaneous fluctuations