Risk of apnoea-related cardiorespiratory instability in preterm infants is modulated by clinical, demographic and dynamic indicators

Abstract Background Apnoea of prematurity is common and may cause desaturation and/or bradycardia. There is marked variability in infants’ cardiorespiratory responses to apnoea, despite standardised clinical thresholds. Factors influencing apnoea-related cardiorespiratory instability and whether instability can be predicted warrant investigation. Methods 181,511 apnoeas >5 s were identified from 146 preterm infants 30% heart rate reduction) and/or oxygen desaturation ( Results Longer duration apnoeas were associated with increased instability, although variability was substantial and 3.6% of apnoeas Conclusions Multiple factors influence cardiorespiratory responses to apnoea. Predictive modelling may enable personalised apnoea definitions, improving individualised care. Impact We investigated variability in cardiorespiratory instability following apnoea in preterm infants. We demonstrate multiple factors which influence the cardiorespiratory changes following apnoea and develop a machine learning model which can accurately predict apnoea-related cardiorespiratory instability. Prediction of cardiorespiratory instability could enable personalised apnoea alarms and inform discharge and treatment decision making.