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. 2017 Apr 27;12(4):e0176670.
doi: 10.1371/journal.pone.0176670. eCollection 2017.

Dynamics and complexity of body temperature in preterm infants nursed in incubators

Kerstin Jost  1   2 , Isabelle Pramana  2 , Edgar Delgado-Eckert  3 , Nitin Kumar  3 , Alexandre N Datta  4 , Urs Frey  4 , Sven M Schulzke  2
Affiliations

Dynamics and complexity of body temperature in preterm infants nursed in incubators

Kerstin Jost et al. PLoS One. .

Abstract

Background: Poor control of body temperature is associated with mortality and major morbidity in preterm infants. We aimed to quantify its dynamics and complexity to evaluate whether indices from fluctuation analyses of temperature time series obtained within the first five days of life are associated with gestational age (GA) and body size at birth, and presence and severity of typical comorbidities of preterm birth.

Methods: We recorded 3h-time series of body temperature using a skin electrode in incubator-nursed preterm infants. We calculated mean and coefficient of variation of body temperature, scaling exponent alpha (Talpha) derived from detrended fluctuation analysis, and sample entropy (TSampEn) of temperature fluctuations. Data were analysed by multilevel multivariable linear regression.

Results: Data of satisfactory technical quality were obtained from 285/357 measurements (80%) in 73/90 infants (81%) with a mean (range) GA of 30.1 (24.0-34.0) weeks. We found a positive association of Talpha with increasing levels of respiratory support after adjusting for GA and birth weight z-score (p<0.001; R2 = 0.38).

Conclusion: Dynamics and complexity of body temperature in incubator-nursed preterm infants show considerable associations with GA and respiratory morbidity. Talpha may be a useful marker of autonomic maturity and severity of disease in preterm infants.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Flow of patients and measurements through the phases of the study.
Fig 2
Fig 2. Scaling exponent alpha (Talpha) over gestational age (GA).
Average Talpha over the first five days of life derived from detrended fluctuation analysis of temperature time series plotted against GA at birth. Multilevel linear regression analysis demonstrated a significant negative association between Talpha and GA at birth (p<0.001, R2 = 0.29).
Fig 3
Fig 3. Scaling exponent alpha (Talpha) over respiratory support.
Talpha grouped by the level of respiratory support present during a temperature measurement. Multilevel linear regression analysis demonstrated a significant positive association between Talpha and stepwise increase of respiratory support from none to continuous positive airway pressure (CPAP), and from CPAP to endotracheal ventilation (p < 0.001, R2 = 0.29).
Fig 4
Fig 4. Scaling exponent alpha (Talpha) over postnatal age.
Talpha decreased from a mean (SD) of 1.67 (0.18) on day one of life to 1.46 (0.22) on day five of life (p<0.001).
See this image and copyright information in PMC

References

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