{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T03:31:28Z","timestamp":1787801488703,"version":"build-2784847793"},"reference-count":44,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2020,7,23]],"date-time":"2020-07-23T00:00:00Z","timestamp":1595462400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["physoc.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Physiology"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:sec><jats:title>Key points<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Non\u2010invasive simultaneous multiparametric monitoring allows the <jats:italic>in vivo<\/jats:italic> evaluation of cerebral and cardiovascular haemodynamic responses to different types of recurrent episodes of intermittent hypoxia and\/or bradycardia, also defined as cardio\u2010respiratory events (CRE), in preterm neonates during postnatal transition.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>By decreasing left cardiac output, bradycardia further contributes to cerebral hypoxia during CRE.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The presence of a haemodynamically significant patent ductus arteriosus results in a deeper impairment of cerebral oxygen status in response to CRE, whereas the brain\u2010sparing remodelling of the fetal circulation resulting from placental insufficiency is associated with more favourable haemodynamic responses to intermittent hypoxia.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>During transition, the haemodynamic impact of CRE is influenced not only by the event type, but also by specific clinical features; this highlights the importance of developing individualized approaches to reduce the hypoxic burden in this delicate phase.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>Abstract<\/jats:title><jats:p>The present observational prospective study aimed to investigate cerebral and cardiovascular haemodynamic responses to different types of cardio\u2010respiratory events (CRE) in preterm infants during postnatal transition, as well as evaluate the impact of relevant clinical characteristics. Infants with gestational age (GA) &lt;32\u00a0weeks and\/or birth weight &lt;1500\u00a0g were enrolled after birth. Cerebral oxygenation index (cTOI), fractional oxygen extraction (cFTOE), cardiac output (CO), cardiac contractility (iCON) and systemic vascular resistances (sVR) were simultaneously monitored over the first 72\u00a0h by near\u2010infrared spectroscopy and electrical velocimetry. CRE were clustered into isolated bradycardia (IB), isolated desaturation (ID) and combined desaturation\/bradycardia (DB). For each parameter, percentage changes from baseline (%\u0394) were calculated. The impact of different CRE types and clinical variables on %\u0394\u00a0was evaluated with generalized estimating equations. In total, 1426 events were analysed. %\u0394cTOI significantly differed among ID, IB and DB (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001), with the latter showing the greatest drop. %\u0394cFTOE decreased significantly during DB (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and ID (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) compared to IB. DB and IB were associated with more negative %\u0394CO (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and more positive %\u0394sVR (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) compared to ID. A slight iCON reduction was observed during DB compared to ID (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.043). Antenatal umbilical Doppler impairment, GA and the presence of a haemodynamically significant patent ductus arteriosus had a significant independent impact on %\u0394cTOI, %\u0394cFTOE and %\u0394CO. During the transitional period, the haemodynamic responses to CRE are influenced by the event type and by specific neonatal characteristics, suggesting the importance of targeted individualized approaches for minimizing the risk of cerebral injury in the preterm population.<\/jats:p><\/jats:sec>","DOI":"10.1113\/jp279730","type":"journal-article","created":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T11:36:18Z","timestamp":1593257778000},"page":"4107-4119","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Cardiovascular and cerebrovascular responses to cardio\u2010respiratory events in preterm infants during the transitional period"],"prefix":"10.1113","volume":"598","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2078-7114","authenticated-orcid":false,"given":"Silvia","family":"Martini","sequence":"first","affiliation":[{"name":"Neonatal Intensive Care Unit St Orsola\u2010Malpighi University Hospital  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