Detection of Neonatal Bradycardia

Study Overview
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Brief Summary
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Apnea-bradycardia is a frequent phenomenon in preterm infants which has been associated with short term complications and alterations in neurodevelopment. Duration and amplitude of the bradycardias depend on the time delay between the beginning of the bradycardia and the intervention of the nurse. The purpose of the study is to test a new method set for early detection of bradycardia in preterm infants.

Detailed Description
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Apnea-bradycardia is a frequent phenomenon in preterm infants which has been associated with short term complications and alterations in neurodevelopment. Duration and amplitude of the bradycardias depend on the time delay between the beginning of the bradycardia and the intervention of the nurse. The purpose of the study is to test in clinical units and in real life a new method set for early detection of bradycardia in preterm infants. Each preterm infant cardio-respiratory traces will be recorded during two 4-hours periods of time (the first one at the time of occurrence of apnea-bradycardias and the second one during the following week). During those periods, the alarms of the monitors usually used in the units will also be recorded through automatic detection and these alarms will be compared with the alarms generated by the algorithm tested, for false positive and precocity of the detection. A false positive alarm is a detection which is not associated with a bradycardia of less than 80 bpm. The system will be considered efficient if it allows an earlier detection of severe bradycardias without increasing the number of false positive detection.

Official Title
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Early Detection of Severe Apnea-bradycardia in Preterm Infants Using Algorithm Fusion

Conditions
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Apnea, Bradycardia

Intervention / Treatment
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* Device: No intervention


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Parents informed consent Presenting with at least 2 significant apnea bradycardia (apnea + decrease in heart rate of more than 33% during at least 4 sec) Exclusion Criteria: Postnatal age of less than 4 days Mechanical ventilation Severe neurological lesion

Ages Eligible for Study
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Minimum Age: 4 Days
Maximum Age: 33 Weeks

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| cohort<br>One group of preterm infants | Device: No intervention<br>* The recordings will be performed in neonatal units with the preterm infant remaining in usual condition with limitations of external stimulation during the study period. The usual monitor will remain in function. The intervention of the nurses in case of apnea will not be modified during the study period. The recording will be obtained from derivation of the signal usually recorded by the monitor in use completed in one centre by a polysomnographic recording (Medtronics France SA), in order to test a possible influence of the sleep status on the detection.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of false positive alarm detections |  | 1 week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Delay between the beginning of the bradycardia and the detection. Sensitivity, specificity, positive predictive value, negative predictive value |  | 1 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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apnea-bradycardias, preterm infants