Ventilatory response to a hyperoxic test is related to the frequency of short apneic episodes in late preterm Neonates
Ventilatory response to a hyperoxic test is related to the frequency of short apneic episodes in late preterm Neonates
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DOI：
10.1203/pdr.0b013e318155868e
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发表时间：
2007-11-01
影响因子：
3.6
通讯作者：
Telliez, Frederic
中科院分区：
文献类型：
--
作者：
Cardot, Virginie;Chardon, Karen;Telliez, Frederic
化疗接受常参与早产儿呼吸暂停的过程。呼吸暂停可能是由颈动脉身体效能下降引起的。然而，当受体受到刺激时，颈动脉体活动的增加也可能通过过度通气后的低碳酸血症引发呼吸暂停。本研究的目的是分析高龄早产儿颈动脉体有效性与短时间呼吸暂停发作之间的关系。对36例早产儿（2.07 +/- 0.26 kg）在睡眠期间进行30秒高氧试验，并在氧气吸入时减少通气，以热中性评价颈动脉体有效性。在高氧试验前后监测血氧饱和度（Sp(o2)）和通气参数。在早上的3小时进食间隔期间记录短时间呼吸暂停（频率和平均持续时间）。测试前SRo2与任何测量的呼吸参数无关。在高氧试验中，较高频率的短时间呼吸暂停发作与更大程度的通气减少有关（p = -0.32; p = 0.01）。颈动脉体反应的增加与呼吸暂停发作频率的增加相关，即使在不伴有氧饱和度降低的情况下也是如此。胎儿或出生后早期低氧血症可能会增加外周化学受体活性，从而引发“过调/过调”情况，进而诱导临界P-o2/P-co2组合和呼吸暂停。
Chemoreception is frequently involved in the processes underlying apnea in premature infants. Apnea could result from a decrease in carotid body effectiveness. However, increased carotid body activity could also initiate apnea through hypocapnia following hyperventilation when the receptors are stimulated. The aim of this study was to analyze the relationship between carotid body effectiveness and short apneic episodes in older preterm neonates. Carotid body effectiveness was assessed at thermoneutrality in 36 premature neonates (2.07 +/- 0.26 kg) by performing a 30-s hyperoxic test during sleep, the oxygen inhalation involving a ventilation decrease. Blood O-2 saturation (Sp(o2)) and ventilatory parameters were monitored before and during the hyperoxic test. Short episodes of apnea (frequency and mean duration) were recorded during the morning's 3-h interfeeding interval. Pretest SRo2 was not related to any of the measured respiratory parameters. A higher frequency of short apneic episodes was linked to a greater ventilation decrease in response to the hyperoxic test (p = -0.32; p = 0.01). Increased carotid body response is correlated with greater apneic episodes frequency, even in the absence of concomitant oxygen desaturation. Fetal or early postnatal hypoxemia could have increased peripheral chemoreceptor activity, which could initiate a "overshoot/undershoot" situation, which in turn could induce a critical P-o2/P-co2 combination and apnea.