Vital sign metrics of VLBW infants in three NICUs: implications for predictive algorithms

Amanda M. Zimmet, Brynne A. Sullivan, Karen D. Fairchild, J. Randall Moorman, Joseph R. Isler, Aaron W. Wallman-Stokes, Rakesh Sahni, Zachary A. Vesoulis, Sarah J. Ratcliffe, Douglas E. Lake

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Continuous heart rate (HR) and oxygenation (SpO2) metrics can be useful for predicting adverse events in very low birth weight (VLBW) infants. To optimize the utility of these tools, inter-site variability must be taken into account. Methods: For VLBW infants at three neonatal intensive care units (NICUs), we analyzed the mean, standard deviation, skewness, kurtosis, and cross-correlation of electrocardiogram HR, pulse oximeter pulse rate, and SpO2. The number and durations of bradycardia and desaturation events were also measured. Twenty-two metrics were calculated hourly, and mean daily values were compared between sites. Results: We analyzed data from 1168 VLBW infants from birth through day 42 (35,238 infant-days). HR and SpO2 metrics were similar at the three NICUs, with mean HR rising by ~10 beats/min over the first 2 weeks and mean SpO2 remaining stable ~94% over time. The number of bradycardia events was higher at one site, and the duration of desaturations was longer at another site. Conclusions: Mean HR and SpO2 were generally similar among VLBW infants at three NICUs from birth through 6 weeks of age, but bradycardia and desaturation events differed in the first 2 weeks after birth. This highlights the importance of developing predictive analytics tools at multiple sites. Impact: HR and SpO2 analytics can be useful for predicting adverse events in VLBW infants in the NICU, but inter-site differences must be taken into account in developing predictive algorithms.Although mean HR and SpO2 patterns were similar in VLBW infants at three NICUs, inter-site differences in the number of bradycardia events and duration of desaturation events were found.Inter-site differences in bradycardia and desaturation events among VLBW infants should be considered in the development of predictive algorithms.

Original languageEnglish
Pages (from-to)125-130
Number of pages6
JournalPediatric research
Issue number1
StatePublished - Jul 2021


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