metodología diagnóstiCa de la dinámiCa CardíaCa neonatal mediante la oCuPaCión esPaCial del atraCtor CaótiCo

Objective: To develop a diagnostic methodology of neonatal cardiac dynamics from fractal geometry, the theory of dynamical systems and spatial occupation of heart attractor in the Box-Counting fractal space. Methodology: initially a mathematical induction was performed with two Holter evaluated clinically as normal and three with acute disease from the Intensive Care Unit (ICU). The sequence of values of heart rate (HR) was generated, taking the maximum and minimum values of the HR/hour and total beats/hour for 21 hours. Heart attractors were constructed and its fractal dimension and their respective spaces of occupation of two grids in fractal space of Box-Counting, were calculated, differentiating between normal and disease. The results of induction were applied to 20 dynamic, five normal and 25 pathological, to confirm the results by a blind study. Results: induction allowed establishing mathematical characteristics that differences between normality and disease by spatial occupation of chaotic attractors, presenting values equal to or greater than 98 in the kg grid for normality, and less than 98 for acute illness; values which were later confirmed in other cases, achieving sensitivity and specificity of 100% and a kappa coefficient of 1. Conclusions: A new physical and mathematical diagnostic with clinical application was developed to evaluate the neonatal cardiac dynamics, which allows early detection of abnormalities with potential gravity and quantitatively indicate the level of intensification of specific alterations, useful for clinical decision making in the ICU.