Análisis comparativo de Pa02 Y SatO2 en el manejo del síndrome de distrés respiratorio del neonato en la unidad de cuidados intensivos neonatales del Hospital Nacional Dos de Mayo durante el periodo 2017-2018

Objetivos: Determinar la asociación entre la PaO2 y la SatO2 en el manejo del síndrome de distress respiratorio del neonato en la Unidad de Cuidados Intensivos Neonatales del Hospital Nacional Dos De Mayo durante el periodo 2017-2018. Materiales y métodos: Esta investigación es un estudio transversal, retrospectivo, observacional de de alcance analítico y de tipo comparativo. Se recopilaron los datos de las historias clínicas de 129 pacientes recién nacidos que fueron diagnosticados con SDRN y posteriormente ingresados a la UCIN. Resultados: El 65% presento una SatO2 de 94-98%, y el 70% presentó una PaO2 entre 81-93 mmHg. No se encontró asociación entre las dos variables anteriormente descritas. Conclusiones: En los neonatos diagnosticados con SDRN internados en UCIN el aumento de los niveles de SatO2 no se ve reflejado en un incremento equivalente de la PaO2. La principal etiología del SDRN en este estudio fue la taquipnea transitoria del recién nacido, en neonatos a término, y no hubo una diferencia significativa en la insidencia con respecto al el sexo. No hubo una asociación estadísticamente significativa entre la SatO2 y la PaO2 con la frecuencia respiratoria, frecuencia cardiaca, el potencial de hidrogeno, el índice PaO2/FiO2, presión arterial de CO2 ni la temperatura.Tesi

Biomedical Signal Analysis of the Brain and Systemic Physiology

Near-infrared spectroscopy (NIRS) is a non-invasive and easy-to-use diagnostic technique that enables real-time tissue oxygenation measurements applied in various contexts and for different purposes. Continuous monitoring with NIRS of brain oxygenation, for example, in neonatal intensive care units (NICUs), is essential to prevent lifelong disabilities in newborns. Moreover, NIRS can be applied to observe brain activity associated with hemodynamic changes in blood flow due to neurovascular coupling. In the latter case, NIRS contributes to studying cognitive processes allowing to conduct experiments in natural and socially interactive contexts of everyday life. However, it is essential to measure systemic physiology and NIRS signals concurrently. The combination of brain and body signals enables to build sophisticated systems that, for example, reduce the false alarms that occur in NICUs. Furthermore, since fNIRS signals are influenced by systemic physiology, it is essential to understand how the latter impacts brain signals in functional studies. There is an interesting brain body coupling that has rarely been investigated yet. To take full advantage of these brain and body data, the aim of this thesis was to develop novel approaches to analyze these biosignals to extract the information and identify new patterns, to solve different research or clinical questions. For this the development of new methodological approaches and sophisticated data analysis is necessary, because often the identification of these patterns is challenging or not possible with traditional methods. In such cases, automatic machine learning (ML) techniques are beneficial. The first contribution of this work was to assess the known systemic physiology augmented (f)NIRS approach for clinical use and in everyday life. Based on physiological and NIRS signals of preterm infants, an ML-based classification system has been realized, able to reduce the false alarms in NICUs by providing a high sensitivity rate. In addition, the SPA-fNIRS approach was further applied in adults during a breathing task. The second contribution of this work was the advancement of the classical fNIRS hyperscanning method by adding systemic physiology measures. For this, new biosignal analyses in the time-frequency domain have been developed and tested in a simple nonverbal synchrony task between pairs of subjects. Furthermore, based on SPA-fNIRS hyperscanning data, another ML-based system was created, which is able distinguish familiar and unfamiliar pairs with high accuracy. This approach enables to determine the strength of social bonds in a wide range of social interaction contexts. In conclusion, we were the first group to perform a SPA-fNIRS hyperscanning study capturing changes in cerebral oxygenation and hemodynamics as well as systemic physiology in two subjects simultaneously. We applied new biosignals analysis methods enabling new insights into the study of social interactions. This work opens the door to many future inter-subjects fNIRS studies with the benefit of assessing the brain-to-brain, the brain-to-body, and body-to-body coupling between pairs of subjects