Spectral analysis of heart rate fluctuations and optimum thermal management for low birth weight infants

Spectral analysis of heart rate variability is studied in 10 healthy growing premature infants to investigate the changes in autonomic balance achieved as a function of changes in skin temperature. Heart rate is obtained from ECG recordings and the power spectrum of beat-to-beat heart rate fluctuations is computed. The infants maintain mean rectal temperature within 36.3-37.2 °C, while skin temperature changes. The respiratory rate does not change at the different servocontrol set points. Heart rate is found to increase slightly, but consistently. The low-frequency band (0.02-0.2 Hz), reflecting the interplay of the sympathetic and parasympathetic tone and known to be maximum at the thermoneutral zone, is maximum at 35.5 and 36 °C and decreases gradually to a lower level at a servocontrol temperature of 36.5-37 °C. The high-frequency band (0.2-2.0 Hz), coinciding with the respiratory peak and reflecting parasympathetic activity, is significantly elevated at 36 °C (p<0.01). The minimum low: high ratio, indicating the minimum sympathetic-parasympathetic balance and possibly reflecting the most comfortable conditions, occurs at 36 °C, although the differences are not statistically significant. Servocontrol skin temperature may thus be adapted, and possibly selected at 36 °C for growing premature infants in an attempt to achieve thermal comfort and more balanced autonomic activity.