Maturation of the initial ventilatory response to hypoxia in sleeping infants

Richardson, Heidi L.; Parslow, Peter M; Walker, Adrian M.; Harding, Richard; Horne, Rosemary Sylvia Claire

doi:10.1111/j.1365-2869.2007.00575.x

Cited by 27 publications

(38 citation statements)

References 30 publications

(64 reference statements)

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“…In addition to standard paediatric polysomnographic recording electrodes (Parslow et al. , 2003, 2004; Richardson et al. , 2007) nasal airflow was measured using a pneumotachograph attached to a silicone rubber nose‐mask (Parslow et al.…”

Section: Methodsmentioning

confidence: 99%

Arousal and ventilatory responses to mild hypoxia in sleeping preterm infants

Verbeek

Richardson

Parslow

et al. 2008

Journal of Sleep Research

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SUMMARY A failure to adequately respond to hypoxia has been implicated in the Sudden Infant Death Syndrome (SIDS). Preterm infants are at increased risk for SIDS, thus we compared ventilatory and arousal responses to mild hypoxia [15% oxygen (O 2 )] in preterm and term infants. Eight preterm and 15 term infants were serially studied with daytime polysomnography during which nasal airflow was monitored by pneumotachograph at 2-5 weeks, 2-3 and 5-6 months. At each age, in both groups, hypoxia induced a significant decrease in oxygen saturation (SpO 2 ) during both active sleep (AS) and quiet sleep (QS). Infants invariably aroused in AS; and in QS either aroused or failed to arouse. In preterm infants arousal latency in AS was longer than in term infants (P < 0.05) at 2-5 weeks. Compared with term infants, preterm infants reached significantly lower SpO 2 levels at 2-5 weeks in both AS and QS non-arousing tests and at 2-3 months in QS. A biphasic hypoxic ventilatory response was observed in QS nonarousing tests in both groups of infants at all three ages. We conclude that the greater desaturation during a hypoxic challenge combined with the longer arousal latency in preterm infants could contribute to greater risk for SIDS.

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Section: Methodsmentioning

confidence: 99%

Arousal and ventilatory responses to mild hypoxia in sleeping preterm infants

Verbeek

Richardson

Parslow

et al. 2008

Journal of Sleep Research

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“…Research in this area has focused on physiological responses to air challenges. In term infants, normal biphasic responses to hypoxia were present at 2–5 weeks, 2–3 months, and 5–6 months postnatal (Richardson et al, 2007; Verbeek et al, 2008). In preterm infants, the ventilatory response to hypoxia appears to transition from a monophasic depressive response at 31.5 weeks post-conception (Alvaro et al, 1992) to a biphasic response by 35.5 weeks post-conception (Martin et al, 1998) and is still present at 45 weeks post-conception (Verbeek et al, 2008).…”

Section: Prematurity and Sidsmentioning

confidence: 99%

“…Likewise, at 1–3 months of age control infants had lower drops in oxygen saturation when exposed to hypoxia/hypercapnia than infants of smoking mothers (Campbell et al, 2001). It is also interesting to note that during hypoxic challenges, preterm infants have greater drops in oxygen saturation early in life (2 weeks to 3 months) compared to later (5–6 months), while term infants tend to maintain oxygen saturation early (2–3 weeks) and become more sensitive at later ages (2–6 months) (Horne et al, 2002; Richardson et al, 2007; Verbeek et al, 2008). Differences such as these may help to account for the earlier occurrence of SIDS in preterm infants.…”

Section: Prematurity and Sidsmentioning

confidence: 99%

The physiological determinants of Sudden Infant Death Syndrome

Garcia¹,

Koschnitzky²,

Ramirez

2013

Respiratory Physiology & Neurobiology

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It is well-established that environmental and biological risk factors contribute to Sudden Infant Death Syndrome (SIDS). There is also growing consensus that SIDS requires the intersection of multiple risk factors that result in the failure of an infant to overcome cardio-respiratory challenges. Thus, the critical next steps in understanding SIDS are to unravel the physiological determinants that actually cause the sudden death, to synthesize how these determinants are affected by the known risk factors, and to develop novel ideas for SIDS prevention. In this review, we will examine current and emerging perspectives related to cardio-respiratory dysfunctions in SIDS. Specifically, we will review: (1) the role of the preBötzinger complex (preBötC) as a multi-functional network that is critically involved in the failure to adequately respond to hypoxic and hypercapnic challenges; (2) the potential involvement of the pre-BötC in the gender and age distributions that are characteristic for SIDS; (3) the link between SIDS and prematurity; and (4) the potential relationship between SIDS, auditory function, and central chemosensitivity. Each section underscores the importance of marrying the epidemiological and pathological data to experimental data in order to understand the physiological determinants of this syndrome. We hope that a better understanding will lead to novel ways to reduce the risk to succumb to SIDS.

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“…In 1992 the American Academy of Pediatrics (AAP) issued a recommendation that ''healthy term infants'' be placed on their backs which resulted in a significant reduction in the incidence of SIDS [6]. Although studies have shown that there is a progressive maturation of the ventilatory response to hypoxia in the first 6 months of life, the actual age at which it converts to the adult type remains controversial [7]. There is some evidence that obstructive sleep apnea and its associated hypoxia may play a significant role in SIDS [8].…”

Section: Introductionmentioning

confidence: 99%