Ventilation and sleep states in newborn infants

Finer, Neil N.; Abroms, Israel F.; Taeusch, H. William

doi:10.1016/s0022-3476(76)80941-9

Cited by 80 publications

(27 citation statements)

References 20 publications

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“…On the other hand, an increased respiratory rate, minute volume and inspiratory pressure at one-tenth of a sec after airway occlusion have been found in REM, when compared to quiet sleep, which may represent an increased central drive in REM sleep (14). Guilleminault et al (20) observed the worst apneic episodes (longest duration and greatest oxygen desaturation), not during REM sleep, but always in quiet or indeterminate sleep.…”

Section: Time (Seconds )mentioning

confidence: 99%

Reflex Apnea from Laryngeal Chemo-Stimulation in the Sleeping Premature Newborn Lamb

1982

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SummaryThe laryngeal chemoreflex was studied during quiet and REM sleep and wakefulness in premature newborn lambs. The response to reflex stimulation with a 5 sec-water infusion was evaluated during 30 sec, as % change in ventilation, heart rate and blood pressure. Apnea, hypertension and bra-rdia were more pronounced during sleep than during watieffilhess, when arousal was not associated with the stimulation. The response was similar during quiet and REM sleep. Arousal, which occurred in 24 and 31% of the tests respectively, resulted in a response comparable to that seen during wakefulness. The respiratory drive was evaluated by measurement of the mean inspiratory flow and was found to be decreased during both sleep states when compared to wakefulness. We propose that during sleep in the newborn period there is a decreased ability to respond to asphyxia possibly due to a functional immaturity of the arterial chemoreceptors. This results in a low incidence of arousal and a delayed termination of the pronounced poststimulus apnea resulting from laryngeal chemoreflex stimulation. SpeculationIn the newborn lamb, quiet and REM sleep have been shown to be more vulnerable states than wakefulness to reflex apnea elicited by laryngeal chemoreflex stimulation with water, probably as a reflection of decreased respiratory drive and a failure to arouse. It is possible that reflex apnea during sleep triggered by a variety of mechanisms may play a role in the pathogenesis of Sudden Infant Death Syndrome (SIDS).The inhibitory effect on respiration of superior laryngeal nerve stimulation was first recognized by Rosenthal in 1862 (43). Several investigators have since studied extensively the reflex elicited by the stimulation of the laryngeal chemoreceptors (5,6,19,21,22,25,26,29,46). Stimulation of the laryngeal chemoreflex (LCR) in the unanesthetized animal elicits a multi-organ response: apnea, swallowing, bradycardia, increase in pulmonary and systemic vascular resistances and blood flow redistribution in the dive pattern with preservation of cerebral and myocardial perfusion. The afferent pathway of the reflex lies in the superior laryngeal nerve. Previous reports in anesthetized newborn animals have shown that this reflex apnea can be lethal (13,26,33,48).SIDS victims usually die during the night, presumably because of failure to recover from apnea during sleep. Both quiet (2,18,20,44) and REM sleep (12,17,18,23,28,48) have been implicated as being vulnerable activity states for apnea in the newborn period, especially in premature infants. A recent study in the unanesthetized adult dog has described the depressed arousal response from REM sleep occurring after LCR stimulation (47); however, little is known about the influence of different activity states on the LCR response in newborn animals.This study was performed in unanesthetized premature newborn lambs in order to evaluate the effects of different activity states on the respiratory and cardiovascular response to laryngeal chemoreflex stimulation. The study lambs wer...

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Section: Time (Seconds )mentioning

confidence: 99%

Reflex Apnea from Laryngeal Chemo-Stimulation in the Sleeping Premature Newborn Lamb

1982

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“…Dynamic alterations in cardiac and respiratory activity are dependent on the maturity and state of "sleep-wakefulness" both in the fetus and the newborn infant (2,17,19). These dynamic events are also influenced by the state of health and disease in the fetus and newborn (2,13).…”

Section: Speculationmentioning

confidence: 99%

Cardiac and Respiratory Activity in Relation to Gestation and Sleep States in Newborn Infants

et al. 1979

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SummaryIn order to provide normative values of heart and respiratory rate and variability in relation to gestation and sleep states, 32 neonates who were free from cardiopulmonary disease were studied during the 1st-6 day of life. The infants were grouped as follows: group A, 9 infants with gestational ages of 27-33 wk; group B, 14 infants with gestational ages of 34-36 wk; and group C, 9 infants with gestational ages of 37-40 wk. Recordings and observations were made during a 1-hr postprandial nap. During active sleep (AS) and quiet sleep (QS), heart rate, short-term and long-term variability of the heart rate, respiratory rate, variability of the respiratory rate and apnea density were measured. Both the long-and short-term heart rate variability was less in preterm infants (group A) than the less immature or full term infants (groups B and C, P < 0.01). Breath-to-breath respiratory variability was not significantly affected by gestational age, whereas percent duration of apnea was less in full term (group C) than the preterm groups of infants during quiet sleep (groups A and B, P < 0.05). There was no significant difference between baseline heart rate, short-term heart rate variability, and respiratory rate during AS and Q S states at any given gestational age. Long-term variations in heart rate, breath-to-breath respiratory variability, and percent duration of apnea were significantly less in QS in comparison to AS at each gestational age group (P < 0.01). Speculation

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“…Hunger, temperature changes and handling of the infant wiU increase RR (Avery and Normand, 1965). Most studies of respiration in newborn infants agree that respiratory rate is higher and more variable during active sleep (Bolton and Herman, 1974;Hatiiom, 1974;Finer, Abroms and Taeusch, 1976).…”

Section: New Born Babiesmentioning

confidence: 99%

“…Other studies used a face mask which may change the RR (Finer, Abroms and Taeusch, 1976). There is a diminution of RR with increasing time since the last feed in sleeping infants (Bolton and Herman, 1974).…”

Section: New Born Babiesmentioning

confidence: 99%

“…In newbom babies, TJ TTOT was between 0.46 and 0.47 during sleep, in smdies using a respiratory inductive plethysmograph (RIP) or a pneumotachograph with a face mask (Stick et al, 1992;Finer, Abroms and Taeusch, 1976). Yau and Fang (1994) This can be achieved by actively intermpting expiration and initiating inspiration before passive deflation of the respiratory system is complete (Hershenson, 1992).…”

Section: Studies Of Respiratory Timing In Healthy Subjectsmentioning

confidence: 99%

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

Herbert¹

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Ventilation and sleep states in newborn infants

Cited by 80 publications

References 20 publications

Reflex Apnea from Laryngeal Chemo-Stimulation in the Sleeping Premature Newborn Lamb

Reflex Apnea from Laryngeal Chemo-Stimulation in the Sleeping Premature Newborn Lamb

Cardiac and Respiratory Activity in Relation to Gestation and Sleep States in Newborn Infants

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

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