Effects of inhaled oxygen (up to 40%) on periodic breathing and apnea in preterm infants

Weintraub, Zalman; Alvaro, RE; Kwiatkowski, Kim; Cates, Don; Rigatto, Henrique

doi:10.1152/jappl.1992.72.1.116

Cited by 56 publications

(27 citation statements)

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“…20,21 This latter mechanism may be mediated by increased nitric oxide release in brainstem regions subserving ventilation 22 and may account for the emergence of decreased breath-to-breath variability of minute ventilation. 4 Thus, our study confirms previous findings indicating that apnea of prematurity can be treated by increasing the Fio 2 . 1 The Fio 2 required to eliminate apnea, however, varies between studies.…”

Section: Discussionsupporting

confidence: 91%

“…In fact, a modest increase in inspired oxygen concentration decreased apnea and periodicity in preterm infants, not via an increase in alveolar ventilation but rather through a decrease in breath-to-breath variability. 4 The effect of SupOx on sleep in infants with chronic neonatal lung disease (CNLD) was also studied; SupOx increased rapid eye movement (REM) sleep and decreased REM arousal in patients with CNLD. 5 A later study, however, indicated that higher oxyhemoglobin saturations decreased sleep efficiency but did not modify REM sleep duration or arousal index.…”

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confidence: 99%

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Effect of Supplemental Oxygen on Sleep Architecture and Cardiorespiratory Events in Preterm Infants

et al. 2002

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Asymptomatic preterm infants exhibit frequent and potentially clinically adverse cardiorespiratory events when assessed in the sleep laboratory. Administration of SupOx to these infants is associated with an increase in the overall duration and percentage TST spent in quiet sleep with reciprocal changes in active sleep. In addition, improvement in respiratory stability is observed with the use of low-flow SupOx, as evidenced by a decrease in apnea, periodic breathing, and bradycardia, without adverse effects on alveolar ventilation.

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Section: Discussionsupporting

confidence: 91%

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confidence: 99%

Effect of Supplemental Oxygen on Sleep Architecture and Cardiorespiratory Events in Preterm Infants

et al. 2002

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“…These findings corroborate our re cent observations, showing that the adminis tration of low inspired oxygen concentrations would make breathing regular without an in crease in minute ventilation. There was, how ever, a decrease in the variances of ventila tion, tidal volume, inspiratory and expiratory times [14], In the present study also, minute ventilation did not change appreciably, but variance of the measurements decreased.…”

Section: Discussionsupporting

confidence: 51%

Profile of Alveolar Gases during Periodic and Regular Breathing in Preterm Infants

Pereira

Reis²,

Landriault³

et al. 1995

Neonatology

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To determine the changes in alveolar PCO₂ (P_ACO₂) and PO₂ (P_AO₂) during periodic and regular breathing epochs in the same infants, we studied 11 preterm infants during quiet sleep (birth weight 1,630 ± 94 g; gestational age 31 ± 1 weeks; postnatal age 32 ± 3 days). A total of 94 breathing/apneic cycles were analyzed and compared with regular periods. During periodic and regular breathing epochs, there were negative correlations of P_AO₂ on P_ACO₂. Short (5 s) and long ( > 5 s) apneas for individual infants occurred along the regression line for that infant. There was not a single overall critical P_ACO₂ below which apnea occurred, but for individual infants the P_ACO₂ and the P_ACO₂ of the breath preceding apnea varied within a limited range. Apneas occurred in clusters of P_ACO₂ and P_AO₂ along the average regression line of P_AO₂ on P_ACO₂. Analysis of the data showed that apnea occurred at the lowest P_ACO₂ and highest P_AO₂ levels if allowance was made for circulation time. During apnea, ‘the best fit’ for the increase in P_ACO₂ and the decrease in P_AO₂ was linear, rather than logarithmic. The findings suggest the following. (1) There is not a single overall critical level of P_ACO₂ for apnea to occur, but in a given infant this level varies within a limited range. This indicates that these infants are likely breathing near the apnea threshold. (2) Short and long apneas appear to occur randomly along the regression of P_AO₂ on P_ACO₂ for a particular infant. (3) The changes in alveolar gases are linear during apnea. The data are consistent with the idea that each infant has an optimum narrow range of P_ACO₂ and P_AO₂ values in which apnea occurs.

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“…For example, infants with minimal airways or airspace disease may have unstable oxyhemoglobin saturation because of periodic breathing (3)(4)(5). Furthermore, it is not clear how often unstable respiratory system mechanics are responsible for the apparent need for supplemental O 2 .…”

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confidence: 99%

Sources of Methodological Variability in Phase Angles from Respiratory Inductance Plethysmography in Preterm Infants

Ulm¹,

Hamvas²,

Ferkol

et al. 2014

Annals ATS

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Rationale: Better phenotypic descriptions are needed for chronic lung disease among surviving premature infants.Objectives: The purpose of this study was to evaluate the potential usefulness of respiratory inductance plethysmography in characterizing respiratory system mechanics in preterm infants at 32 weeks postmenstrual age.Methods: Respiratory inductance plethysmography was used to obtain the phase angle, F, to describe rib cage and abdominal dyssynchrony in 65 infants born between 23 and 28 weeks gestation, all of whom were studied at 32 weeks postmenstrual age. Up to 60 breaths were evaluated for each subject. Sources of intrasubject variability in F arising from our methods were explored using mechanical models and by evaluating interobserver agreement. Measurements and Main Results:The mean F from infants ranged from 5.8-162.9 8 , with intrasubject coefficients of variation ranging from 11-123%. On the basis of the mechanical model studies, respiratory inductance plethysmography recording and analysis software added ,2.3% to the intrasubject variability in F. Potential inconsistencies in breaths selected could have contributed 8.1%, on average, to the total variability. The recording sessions captured 22.8 6 9.1 minutes of quiet sleep, and enough breaths were counted to adequately characterize the range of F in the session.Conclusion: F is quite variable during even short recording sessions among preterm infants sleeping quietly. The intrasubject variability described herein arises from the instability of the rib cage and abdominal phase relationship, not from the recording and analytical methods used. Despite the variability, F measurements allowed the majority (80%) of infants to be reliably categorized as having relatively synchronous or dyssynchronous breathing. Respiratory inductance plethysmography is easy to use and should prove useful in quantifying respiratory mechanics in multicenter studies of preterm infants.

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Effects of inhaled oxygen (up to 40%) on periodic breathing and apnea in preterm infants

Cited by 56 publications

References 0 publications

Effect of Supplemental Oxygen on Sleep Architecture and Cardiorespiratory Events in Preterm Infants

Effect of Supplemental Oxygen on Sleep Architecture and Cardiorespiratory Events in Preterm Infants

Profile of Alveolar Gases during Periodic and Regular Breathing in Preterm Infants

Sources of Methodological Variability in Phase Angles from Respiratory Inductance Plethysmography in Preterm Infants

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