Ocena aktywności autonomicznego układu nerwowego na podstawie parametrów zmienności zatokowego rytmu serca u dzieci urodzonych przedwcześnie — przegląd piśmiennictwa

Introduction. Preterm birth, despite the constant development of medicine and improved perinatal care, remains one of the greatest challenges in obstetrics. A prematurely born child presents a number of disorders, including abnormalities of the autonomic nervous system (ANS), which affect, among others, the functioning of the heart muscle. One method used to assess the influence of ANS activity on heart rate is the analysis of heart rate variability (HRV), which gives an indirect picture of its influence on the ability to adapt the systolic function of the ANS to external stimuli. The aim of this study was to evaluate the activity of the autonomic nervous system on the basis of values of HRV parameters in children born prematurely on the basis of a literature review. Material and methods. The literature review was carried out in accordance with PRISMA statement. Medical databases were reviewed including MEDLINE/PubMed, ProQest, PEDro, Cochrane, and Embase using the key phrases: ‘heart rate variability’ in combination with ‘preterm infants’. Results. Between 1997 and 2018, 26 publications meeting the inclusion criteria were identified, of which 15 were selected for detailed analysis. Selected time and frequency domain HRV parameters were analysed in the review. Conclusions. Preterm infants are susceptible to heart rhythm control disorders by the autonomic nervous system expressed by rapid and temporary changes in heart rate. They have higher heart rate and selected HRV parameters, suggesting a dominance of sympathetic activity in heart rate control. In addition, existing studies are not sufficiently systematic to be able to be compared to each other. Therefore, this subject requires further research.