Cardiorespiratory Patterns in Infants Presenting with Apparent Life-Threatening Episodes

Southall, D P; Janczynski, R.E.; Alexander, J. R.; Taylor, Virginia; Stebbens, V A

doi:10.1159/000243167

Cited by 10 publications

(4 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interpreted in this light, our study indicates that the SIDS infants were not abnormal in the stability of this control system at the time these data were collected. Although an increased prevalence of short cycle time patterns, periodic breathing, was seen in one infant, and previously has been demonstrated in three of 16 term infants who died of SIDS (16), this is clearly not representative of most of the SIDS population. Note that this infant &ed of SIDS 9% mo after the data were recorded, whereas infants who died within 2 wk of the recording showed no abnormality in short cycle time patterns.…”

Section: Discussioncontrasting

confidence: 59%

See 1 more Smart Citation

Analysis of Breathing Patterns in a Prospective Population of Term Infants Does Not Predict Susceptibility to Sudden Infant Death Syndrome

1990

View full text Add to dashboard Cite

ABSTRACT. Oscillatory patterns in ventilation have been seen in term and premature infants and are indicative of the stability of the respiratory blood gas feedback control system. Apneas are related to these patterns and apnea duration is correlated with pattern characteristics. In our study breathing patterns were analyzed in recordings from 10 term infants who subsequently died of sudden infant death syndrome (SIDS) and 10 control infants matched for birth wt, gestational age, and postnatal age. Subjects were drawn from a prospectively studied population of 9856 infants. Breath-by-breath minute ventilation was estimated in each of these 24-h recordings and oscillatory patterns were detected using a comb of digital bandpass filters. Confidence limits on the filter output and a bad data flag for rejection of data during gross body movements or crying insured that onlv significant Datterns in ventilation were " -evaluated. Pattern prevalence and amplitude were compared in three frequency regimes: 6-to 87-s cycle times, 6-to 28-s cycle times, and 28-to 87-s cycle times. There was no significant difference between the SIDS and the control infants in any of these pattern comparisons (paired t and Wilcoxon paired rank sum tests, p < 0.05). In light of the normal breathing patterns found in the SIDS infants, it is unlikely that susceptibility to SIDS is distinguished, at the time of these recordings, by instability of the respiratory blood gas feedback control system. (Pediatr Res 27: 113-117,1990) Abbreviation SIDS, sudden infant death syndrome A close relationship between apnea and SIDS has been postulated since the early 1970s when Steinschneider (1) reported that two of five infants with documented prolonged sleep apnea died of SIDS. Not only prolonged sleep apnea but also excessive amounts of periodic breathing, as seen in some populations of so called "near-miss" SIDS infants (2, 3), have been postulated as indications of increased susceptibility to SIDS. In a prospective study of 9856 infants, Southall et al. (4,5 ) found that neither prolonged apneic pauses nor quantities of periodic breathing could identify susceptibility to SIDS.Waggener et al. (6,7) reported that most apneas seen in term and premature infants were not isolated or random events, but rather were related to underlying oscillatory breathing patterns Supported by NIH Grants HD20909 and HD2 139 1.as might be characterized by a periodic waxing and waning of ventilation. For example, periodic breathing as clinically observed is a particularly strong oscillatory breathing pattern. Duration of apnea was found to be correlated with the cycle time and amplitude of the accompanying pattern, and negatively correlated with the mean minute ventilation (7). They suggested that the oscillatory breathing patterns were characteristic of the stability of the respiratory control system and that the longer cycle time patterns (30 to 90 s cycle time) were of particular importance because longer apneas were associated with such patterns (6, 7). We have applied...

show abstract

Section: Discussioncontrasting

confidence: 59%

“…2, graph A). This infant has been identified in previous analyses as having an inordinate amount of periodic f l 1 CYCLE TIMES s 28 SEC breathing (16). Note that the other nine SIDS infants have on average slightly, and not significantly, lower amplitude and less prevalent short cycle time patterns than the non-SIDS infants.…”

Section: Resultsmentioning

confidence: 63%

Analysis of Breathing Patterns in a Prospective Population of Term Infants Does Not Predict Susceptibility to Sudden Infant Death Syndrome

1990

View full text Add to dashboard Cite

show abstract

“…The respiratory waveforms derived from the capsule were not recorded in real time, precluding first hand validation of the detection of respiratory motion and exclusion of motion artefact. This form of breath detection has; however, been previously validated alongside respiratory inductance plethysmography as a trigger of noninvasive ventilation, and has long been used as a method of detecting central apnea . In common with other methods used in this setting, capsule pneumography cannot detect obstructive apnea in infants on noninvasive respiratory support.…”

Section: Discussionmentioning

confidence: 99%

“…This form of breath detection has; however, been previously validated alongside respiratory inductance plethysmography as a trigger of noninvasive ventilation, 46 and has long been used as a method of detecting central apnea. 47 In common with other methods used in this setting, capsule pneumography cannot detect obstructive apnea in infants on noninvasive respiratory support. The abdominal capsule was positioned in the subxiphisternal position to the right of the midline to maximize detection of inspiratory effort whilst allowing time in prone position.…”

Section: Regression Analysismentioning

confidence: 99%

Physiological instability after respiratory pauses in preterm infants

Marshall

Ali

et al. 2019

Pediatric Pulmonology

View full text Add to dashboard Cite

Background The factors influencing the severity of apnea‐related hypoxemia and bradycardia are incompletely characterized, especially in infants receiving noninvasive respiratory support. Objectives To identify the frequency and predictors of physiological instability (hypoxemia—oxygen saturation (SpO2) <80%, or bradycardia—heart rate (HR) < 100 bpm) following respiratory pauses in infants receiving noninvasive respiratory support. Methods Respiratory pause duration, derived from capsule pneumography, was measured in 30 preterm infants of gestation 30 (24‐32) weeks [median (interquartile range)] receiving noninvasive respiratory support and supplemental oxygen. For identified pauses of 5 to 29 seconds duration, we measured the magnitude and duration of SpO2 and HR reductions over a period starting at the pause onset and ending 60 seconds after resumption of breathing. Temporally clustered pauses (<60 seconds separation) were analyzed separately. The relative contribution of respiratory pauses to overall physiological instability was determined, and predictors of instability were sought in regression analysis, including demographic, clinical and situational variables as inputs. Results In total, 17 105 isolated and 9180 clustered pauses were identified. Hypoxemia and bradycardia were more likely after longer duration and temporally‐clustered pauses. However, the majority of such episodes occurred after 5 to 9 second pauses given their numerical preponderance, and short‐lived pauses made a substantial contribution to physiological instability overall. Birth gestation, hemoglobin concentration, form of respiratory support, caffeine treatment, respiratory pause duration and temporal clustering were identified as predictors of instability. Conclusions Brief respiratory pauses, especially when clustered, contribute substantially to hypoxemia and bradycardia in preterm infants.

show abstract

Heart rate variability in infants subsequently suffering sudden infant death syndrome (SIDS)

Antila

Välimäki

Mäkelä

et al. 1990

Early Human Development

View full text Add to dashboard Cite

Cardiorespiratory Patterns in Infants Presenting with Apparent Life-Threatening Episodes

Cited by 10 publications

References 12 publications

Analysis of Breathing Patterns in a Prospective Population of Term Infants Does Not Predict Susceptibility to Sudden Infant Death Syndrome

Analysis of Breathing Patterns in a Prospective Population of Term Infants Does Not Predict Susceptibility to Sudden Infant Death Syndrome

Physiological instability after respiratory pauses in preterm infants

Heart rate variability in infants subsequently suffering sudden infant death syndrome (SIDS)

Contact Info

Product

Resources

About