Oxygen saturation and breathing patterns in infancy. 1: Full term infants in the second month of life.

Abstract

Overnight 12 hour tape recordings were made of arterial oxygen saturation (SaO2, pulse oximeter in the beat to beat mode) and abdominal wall breathing movement on 67 healthy, full term infants between the ages of 29 and 54 (median 39) days. The median baseline SaO2 during regular breathing was 99-8% (range 97-0-100%). Fifty four infants (81%) had shortlived episodes during which SaO2 fell to 80% or less (desaturation); the median rate was 0-9 desaturations/hour, and the median duration of each desaturation was 1-2 seconds. The 97th centile value for the duration of all episodes in which SaO2 fell to 680% was 4-0 seconds. The frequency of desaturations was significantly higher, and their duration significantly longer, when the breathing pattern was non-regular rather than regular. The percentage of apnoeic pauses (¢4 seconds in duration) followed by a desaturation was higher during non-regular than regular breathing; it was particularly high during periodic breathing.A knowledge of normal variability of baseline measurements of oxygenation and of the relationship between oxygenation and breathing patterns in infants is essential to the use of pulse oximetry in clinical practice.

Randomized, Controlled Trial of Oral Creatine Supplementation (Not Effective) for Apnea of Prematurity

“…Periodic breathing was defined as the occurrence of Ն3 apneic pauses of Ն4 seconds, each separated by Ͻ20 breaths and expressed as a percentage of total artifact-free recording time. 12 Apneas Ն10 seconds occurring during periodic breathing were handled as periodic breathing.…”

“…It is closely related but not identical to quiet sleep. 12 Baseline values for Spo 2 and heart rate were calculated as the mean of the respective values, measured over 5 successive breaths, at the center of each episode of regular breathing pattern, at least 10 seconds away from sighs or apneic pauses. Respiratory rate was calculated as the mean of values counted over 1 minute at the center of each episode of regular breathing pattern.…”

Hypoxia Challenge Testing in Neonates for Fitness to Fly

“…It is true that active sleep, changes of position (which can influence the obstruction of the upper airway), and feeding may have an impact on oxygen saturation. [5][6][7] Therefore, we decided to standardize conditions as much as possible and tried to avoid introducing variables. The BTS guidelines do not establish recommendations in reference to the mentioned conditions even though they can have an important impact on the results.…”

“…3 Premature infants have more apneic pauses and periodic breathing when they reach term than term infants, and apneic pauses may be triggered by chronic hypoxemia. [4][5][6] Thus, studies testing term infants and premature infants during the first months of life for fitness to fly have been ruled out by most other researchers despite the fact that the number of families wanting to take their newborns on flights shortly after delivery has increased. [7][8][9][10][11] The British Thoracic Society (BTS) has published guidelines for infants stating that term newborns (>37 weeks) should wait 1 week after birth term before traveling, premature infants who have not reached term should have in-flight oxygen of 1 to 2 L/min (grade C evidence), and premature infants <1 year old with neonatal chronic respiratory problems should undergo hypoxia challenge testing (HCT).…”

Analysis of respiratory rate and the respiratory cycle in infants and children using an optical sensor

“…Regular breathing pattems are signified by episodes of at least one minute in duration where abdominal wall movement waveform is steady in rate and ampUmde. A regular breathing pattem is highly correlated with a state of quiet sleep (Stebbens et al, 1991). Periods not conforming to this defiiution, and those in which the pattem is dismpted by body movements, sighs, or apnoeic pauses are classified as irregular.…”