Experimental study on a causal relationship between sleeping in a face-down position and sudden death in infants

俯卧位睡眠与婴儿猝死因果关系的实验研究

• 批准号: 16590549
• 负责人: MUKAI Toshiji
• 金额: $ 1.79万
• 依托单位: St.Marianna University School of Medicine
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2004
• 资助国家: 日本
• 起止时间: 2004 至 2005
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-16590549/
• 关键词: Sudden Infant Death Syndrome; prone sleeping; animal testing; re-breathing; suffocation; 乳幼児突然死症候群(SIDS); うつぶせ寝

An animal experiment was conducted to investigate whether covering both nose and mouth by bedding may cause lethal hypoxemia in healthy infants.[Methods]A mask of a dead infant was made of polyurethane resin, and a vertical load of 1.5 kg was added. An endotracheal tube was placed in a piglet and linked to the nasal cavity of the mask, through which the piglet breathed. Blood pressure (BP), heart rate (HR), arterial oxygen saturation (O_2sat), respiratory rate (RR), expired air oxygen concentration (exO_2) and expired air carbon dioxide concentration (exCO_2) were monitored continuously, and arterial oxygen concentration (PaO_2) and arterial carbon dioxide concentration (PaCO_2) were monitored as necessary. For bedding, soft and hard Japanese beds (futons) and a mattress dedicated for prone sleeping were used.[Results]1.When the mask was placed in a face-down position on the soft futon, the animal immediately started forced inspiration. O_2sat and exO_2 quickly decreased within three minutes, and PaO_2 decreased to 29.8 mmHg three minutes later. When the mask was placed in a face-up position three minutes later, respiratory condition and all test values quickly returned to normal.2.When the mask was correspondingly placed on the hard futon, PaO_2 gradually decreased to 44.2 mmHg five minutes later, 30.1 mmHg 25 minutes later and 31.0 mmHg 35 minutes later. O_2sat and exO_2 also gradually decreased, and the animal died 50 minutes later.3.When the mask was correspondingly placed on the mattress dedicated for prone sleeping, PaO_2 decreased to 36 mmHg five minutes later. O_2sat and exO_2 quickly decreased for the first three minutes and thereafter decreased as gradually as BP, HR and RR did, and the animal died 25 minutes later.[Conclusion]These findings suggest that infants may quickly die from hypoxemia caused by both nose and mouth being covered by bedding while they sleep in a prone position, especially in a face-down position.

通过动物实验研究了用被褥捂住口鼻是否会引起健康婴儿的致死性低氧血症。[方法]用聚氨酯树脂制作一个死婴面罩，在面罩上施加1.5kg的垂直载荷。将气管内导管放置在仔猪体内并连接到面罩的鼻腔，仔猪通过该鼻腔呼吸。连续监测血压（BP）、心率（HR）、动脉血氧饱和度（O2sat）、呼吸频率（RR）、呼出气氧浓度（exO2）和呼出气二氧化碳浓度（exCO2），必要时监测动脉血氧浓度（PaO2）和动脉二氧化碳浓度（PaCO2）。床上用品方面，使用了柔软和坚硬的日式床（蒲团）以及专用于俯卧的床垫。[结果] 1.当面罩以面朝下的姿势放置在软床上时，动物立即开始强制吸气。O_2sat和exO_2在3分钟内迅速下降，3分钟后PaO_2降至29.8 mmHg。2.将面罩相应地放在硬床垫上，5 min后PaO_2逐渐下降至44.2 mmHg，25 min后降至30.1 mmHg，35 min后降至31.0 mmHg。O_2sat和exO_2也逐渐下降，50分钟后动物死亡。3.将面罩相应地放在俯卧专用床垫上，5分钟后PaO_2降至36 mmHg。O_2sat和exO_2在前3分钟迅速下降，此后随着BP、HR和RR逐渐下降，25分钟后动物死亡。[结论]婴儿俯卧位睡眠时，尤其是俯卧位睡眠时，口鼻被被褥遮盖，可导致低氧血症，使其迅速死亡。