Biomedical subjects

M Stefanski

Publications and source records attributed to M Stefanski.

7 recordsLinked to original sources

PubMed1995

Methodological issues in coding sleep states in immature infants.

Thirty-five healthy, premature infants, ranging from 30-39 weeks postconceptional age, were observed continuously for 6 to 24 hr. Behavioral state and electroencephalographic patterns were coded for each minute. Using these data, three questions regarding coding of states of sleep were addressed: What is the concordance between behavioral codes and specific EEG patterns? Does the concordance between behavioral codes and EEG patterns change with postconceptional age? What range of error can be expected when observation periods shorter than 24-hr are used to estimate the daily distribution of quiet sleep (QS) and active sleep (AS)? With behavioral codes as the standard, concordances of EEG patterns for QS and AS were 72.5 and 92.1% respectively. With EEG patterns as the standard, behavioral codes for QS and AS agreed 83.0 and 88.9%. Agreement between behavioral codes and EEG patterns for QS increased with age. Finally, variation in estimates of the daily distribution of QS and AS decreased dramatically as the length of observation increased from 3 to 24 hr.

Arousal↗

PubMed1987

Energy expenditure, energy balance, and composition of weight gain in low birth weight infants fed diets of different protein and energy content.

The effect of energy and protein intakes on energy expenditure, energy balance, and amount and relative rate of both protein and fat deposition in new tissue was investigated in 19 low birth weight infants whose mean protein and energy intakes, respectively, were 2.24 g/kg/d and 113 kcal/kg/d (formula A, n = 8), 3.6 g/kg/d and 115 kcal/kg/d (formula B, n = 5), and 3.5 g/kg/d and 149 kcal/kg/d (formula C, n = 6). The higher energy intake (formula C) but not the higher protein intake (formula B) resulted in greater energy expenditure. Both the higher protein (formula B vs formula A) and higher energy intakes (formula C vs formula B) resulted in greater weight gain secondary, in group B, to a greater absolute rate of protein deposition and, in group C, to a greater absolute rate of fat deposition. The relative composition of the new tissue deposited reflected the proportional intakes of protein and energy. The numerical value of the protein/fat ratio (g/g) of the new tissue deposited by infants fed formulas A and C, the protein contents of which were low relative to energy contents, were similar and significantly lower than the numerical value of the protein/fat ratio of the new tissue deposited by infants fed formula B, which had a higher protein content relative to energy content. These findings suggest that the composition of weight gain is related to both the absolute amounts and the proportions of dietary protein and energy; thus, both must be considered in formulation of nutritional regimens for LBW infants.

Body Weight↗

PubMed1986

An analysis of the variability in estimates of bioenergetic variables in preterm infants.

Estimates of average daily energy expenditure and minimal observed oxygen consumption are commonly used to characterize the energy metabolism of neonates. Yet, the errors inherent in these estimates have not been defined. Using measurements of oxygen consumption and carbon dioxide production made in healthy growing low birth weight infants during eight consecutive 3-h interfeeding epochs, we have determined the variability in the mean oxygen consumption, carbon dioxide production, respiratory quotient, total daily energy expenditure, and the minimal observed oxygen consumption among the feeding epochs. The coefficient of variation for oxygen consumption ranged from 3.1 to 9.1%, for minimal observed oxygen consumption from 3.7 to 16.7%, for carbon dioxide production from 3.3 to 7.4%, and for total daily energy expenditure from 2.9 to 7.6%. The SDs for respiratory quotient ranged from 0.008 to 0.066. From these 24-h data we have calculated the error in predicting daily estimates of the mean values for these variables if observations are made for less than 24 h. As expected, this error decreases with increasing duration of observation. These data should prove useful in the design and interpretation of investigations of neonatal energy expenditure.

Carbon Dioxide↗

PubMed1984

A scoring system for states of sleep and wakefulness in term and preterm infants.

We designed and validated a system for determining the state of sleep or wakefulness in both term and preterm infants. The system is based on independent assessments of behavioral and electroencephalographic (EEG) patterns. Overall agreement between observers in coding individual behavioral patterns was 77.6%. Agreement between observers in coding EEG patterns was 87.4%. Designation of an infant's state is made by combining concurrent behavioral and EEG scores into a single two-number code. The distribution of sleep state for eight infants greater than 36 wk postconceptional age (PCA) was the following: quiet sleep (QS), 30.4%; active sleep (AS), 50.0%; indeterminate sleep (IS), 11.4%, and wakefulness (W), 7.5%. The distribution of sleep state for 15 infants less than 36 wk PCA was as follows: QS, 18.9%; AS, 52.9%; IS, 16.4%; and W, 10.5%. Our experience with the system suggests that it is useful for relating sleep state to physiologic variables during neonatal experimental studies.

Child Behavior↗

PubMed1983

Instrumentation for the continuous measurement of gas exchange and ventilation of infants during assisted ventilation.

A system of instrumentation for continuous measurement of oxygen consumption (VO2), carbon dioxide production (VCO2) and minute ventilation (V1) in human newborns on assisted ventilation is described. VO2 and VCO2 are measured by open-circuit indirect calorimetry utilizing a Servomex OA 184 differential paramagnetic oxygen analyzer and a Beckman LB 2 infrared CO2 analyzer. Minute volume is measured with a body plethysmograph. Bench performance is described, limitations of the system are defined, and sample clinical data are presented. The instrumentation can measure safely, accurately, and continuously physiologic variables in sick infants on assisted ventilation.

Humans↗

PubMed1981

Continuous measurement of minute ventilation and gaseous metabolism of newborn infants.

A system of instrumentation for continuous measurement of gaseous metabolism and minute volume (VI) in the human newborn is described. O2 uptake and CO2 production are measured by open-circuit techniques utilizing a Servomex OA184 differential paramagnetic O2 analyzer and a BEckman LB-2 infrared CO2 analyzer. VI is measured with bias-flow pneumotachometry. Bench performance is described, methodological errors are defined, and clinical data are presented. The instrumentation is capable of safe, accurate, and continuous measurement of respiratory and metabolic variables in low-birth-weight infants.

Calorimetry↗

PubMed1981

Spontaneous variability in minute ventilation oxygen consumption and heart rate of low birth weight infants.

Continuous measurements of minute ventilation (VI), oxygen consumption (VO2), heart rate (HR), activity, and temperature were made in eleven low birth weight infants during the interval between feedings. Significant increases in VI, VO2, and HR were noted between quiet and active sleep. (VI Active - VI Quiet/VI Quiet) X 100 = 18.4% VO2 Active - VO2 Quiet/VO2 Quiet) X 100 = 10.1% and HR Active - HR Quiet/HR Quiet) X 100 = 6.4%. Significant differences were also noted within epochs of the same state of sleep: mean slope VI versus time in epoch (t) = -156 ml/kg . min/hr, VO2 versus t. = 1.49 ml/kg . min/hr and HR versus t = -15.0 beats/min/hr. Differences between successive epochs of the same state of sleep were also observed: VI, +5.9 to 46.6%; VO2, 4.7 to 24.6%; HR, 1.0 to 9.7%. These differences were related to the length of time after feeding. These data indicate that steady state conditions do not occur in growing low birth weight infants and that the design of studies of respiration and metabolism in these infants should include continuous assessment of the state of sleep or activity and time after feeding to ensure that experimental and control periods are truly comparable.

Heart Rate↗