Upper airway chemoreflex responses to saline and water in preterm infants

Davies, Alison; Koenig, Joel; Thach, Bradley T.

doi:10.1152/jappl.1988.64.4.1412

Cited by 131 publications

(87 citation statements)

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“…Review of the literature has yielded an estimated 50 studies assessing LCR in newborn mammals, including human infants. From these studies, we were able to find only 11 studies performed in the absence of anesthesia and sedation, either in lambs or piglets (8,9,18,19,20,22,33) or in human infants (3,23,25,26). However, two of these studies did not take into account state of alertness (3,9), although two others injected liquids through a tracheostomy toward the subglottal region (8,18), hence putting in question the specificity of the receptors (supraglottal, subglottal, and/or tracheobronchial?)…”

Section: Discussionmentioning

confidence: 99%

Laryngeal chemoreflexes induced by acid, water, and saline in nonsedated newborn lambs during quiet sleep

St-Hilaire¹,

Nsegbe²,

Gagnon-Gervais³

et al. 2005

Journal of Applied Physiology

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Section: Discussionmentioning

confidence: 99%

Laryngeal chemoreflexes induced by acid, water, and saline in nonsedated newborn lambs during quiet sleep

St-Hilaire¹,

Nsegbe²,

Gagnon-Gervais³

et al. 2005

Journal of Applied Physiology

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“…The present results concerning the description of the synaptic interactions within the NTS and SLN, SN and HDA inputs may have considerable clinical significance in the context of the sudden infant death syndrome. The stimulation of mechanolaryngeal and other upper airway receptors is a major cause of apnoea in newborn infants (Davies, Koenig & Thach, 1988). This is accompanied by bradycardia and systemic hypotension.…”

mentioning

confidence: 99%

Hypothalamic modulation of laryngeal reflexes in the anaesthetized cat: role of the nucleus tractus solitarii.

Dawid-Milner¹,

Silva-Carvalho²,

Goldsmith³

et al. 1995

The Journal of Physiology

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1. This investigation was initiated because activation of laryngeal afferents, either by electrical stimulation of the superior laryngeal nerve (SLN) or by natural stimulation of receptors in the laryngeal mucosa, results in a cardiorespiratory response comprising bradycardia, hypotension and apnoea (phrenic nerve activity was suppressed). This pattern of response is qualitatively equivalent to the response that is evoked on activation of the arterial baroreceptors. 2. Preliminary studies indicated that the effects of activating the SLN were suppressed during stimulation in the hypothalamic defence area (HDA) at points that also blocked the effects of baroreceptor stimulation. 3. Recordings were taken from seventy-two neurones localized within the ipsilateral nucleus tractus solitarii (NTS) whose activity was modified by SLN stimulation. Sixty neurones responded with an EPSP on SLN stimulation; nine of these had an inspiratory firing pattern. Five neurones were seen to receive an IPSP on SLN stimulation. 4. Five respiratory SLN-activated neurones were unresponsive to stimulation of the other nerve inputs, whilst four received convergent EPSP inputs on sinus nerve (SN) stimulation. One cell of these four also received inputs from the aortic and the vagus nerves. Sixty-one non-respiratory SLN-activated neurones also received convergent inputs from the sinus nerve. Of these, fifty displayed an EPSP, four an IPSP and seven an EPSP-IPSP. Fifteen neurones also received inputs from the aortic nerve and seventeen from the vagus. 5. From the population of neurones affected by SLN stimulation, twenty-four of seventy were also influenced by HDA stimulation (3 were respiratory cells). Sixteen of these responses consisted of an EPSP (2 respiratory cells), five of an IPSP (1 respiratory cell) and three of an EPSP-IPSP. 6. In neurones receiving an IPSP on HDA stimulation, the SLN-evoked excitatory response was reduced throughout the period of HDA-evoked inhibition. These neurones were all shown to receive excitatory inputs from the arterial baroreceptors and laryngeal mechanoreceptors. 7. Additionally, in the thirty-seven neurones that were excited by SLN stimulation but received no direct synaptic input on HDA stimulation, a conditioning stimulus to the HDA evoked a block of SLN-evoked responses without an accompanying change in membrane potential. Several of these neurones were also affected by both baroreceptor and laryngeal mechanoreceptor stimulation. 8. These observations are discussed in the context of the role of the NTS in cardiorespiratory control. The potential importance of these interactions in respiratory distress are highlighted and the implications for the organization of central pathways for the control of autonomic and respiratory function are discussed.

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“…Penetration of food into the airway is common and may arise from failure to close the airway during swallow or to clear the food bolus from the pharynx. Newborn infants have a poorly developed cough reflex (5). Laryngeal penetration may lead to food entering the lung parenchyma, leading to inflammation and secondary infection.…”

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confidence: 99%

The Relationship between Rhythmic Swallowing and Breathing during Suckle Feeding in Term Neonates

1992

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ABSTRACT. Little is known of the development of efficient coordination between suckle feeding and breathing in human infants. To establish baseline data, we recorded breathing and swallowing activity during bottle feeds in 23 infants at 14-48 h postnatal age. Most swallows (overall mean 68%) were organized into runs, with intervals starting at 0.6-0.8 s and slowing to 1-1.3 s after 30-40 s. The proportion of run swallows to total swallows increased significantly with age. Swallow intervals were regular (coefficient of variation = 18-38%) compared with breathing (coefficient of variation = 50%). Both breathing rate and tidal volume were significantly reduced by the onset of suckle feeding, and the pattern of respiratory airflow became markedly irregular. Mild transient desaturation was common, but was not accompanied by changes in heart rate. Swallows could occur in all phases of breathing. Overall, equal numbers of swallows were preceded by expiration and inspiration, but twice as many were followed by expiration compared with inspiration. Swallows were classified by the respiratory phases both preceding and following the swallow. Swallows occurred in all possible classifications in each of the infants studied. The incidence of the most frequent classification (inspiration-swallowexpiration), was 24% overall (individual range 5-50%). The phase relation between swallows and breaths changed frequently but showed occasional short periods of stability during which the breathing became regular and tidal volume increased. We conclude that at <48 h the normal infant has little coordination between swallowing and breathing rhythms and maintains rhythmic swallowing at the expense of eupnea. (Pediatr Res 31: 619-624,1992)

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Upper airway chemoreflex responses to saline and water in preterm infants

Cited by 131 publications

References 0 publications

Laryngeal chemoreflexes induced by acid, water, and saline in nonsedated newborn lambs during quiet sleep

Laryngeal chemoreflexes induced by acid, water, and saline in nonsedated newborn lambs during quiet sleep

Hypothalamic modulation of laryngeal reflexes in the anaesthetized cat: role of the nucleus tractus solitarii.

The Relationship between Rhythmic Swallowing and Breathing during Suckle Feeding in Term Neonates

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