Breathing, transcutaneous blood gases, and CO2 response in SIDS siblings and control infants during sleep

1993 ◽  
Vol 74 (1) ◽  
pp. 88-102 ◽  
Author(s):  
T. Schafer ◽  
D. Schafer ◽  
M. E. Schlafke
Keyword(s):  
Blood Gases ◽  
Periodic Breathing ◽  
Sleep Time ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Breathing Patterns ◽  
Co2 Response ◽  
Cross Sectional ◽  
Apnea Duration ◽  
Age Related

Age-related changes of 20 variables describing breathing patterns, transcutaneous blood gases, and estimated CO2 response during sleep were examined in a cross-sectional study of 30 healthy control infants and 150 healthy siblings of sudden infant death syndrome victims within the first 18 mo of life. Whole-night measurements were performed using noninvasive respiratory induction plethysmography and transcutaneous blood gas electrodes. Each candidate for the study was extensively screened and found to be healthy. Mean transcutaneous PCO2 (PtcCO2, median 40.3 Torr) and maximum PtcCO2 (median 44.8 Torr), as well as the estimated ventilatory response to inhalation of 2% CO2 in air during regular breathing, causing a 20–36% increase of ventilation per Torr PtcCO2, were not related to postnatal age. In contrast, paradoxical breathing decreased from 49.5 to 0% of total sleep time (TST), periodic breathing from 5.5 to 0% TST, and respiratory rate during regular breathing from 40 to 22 breaths/min; the portion of regular breathing increased from 32 to 55% TST and mean and minimum transcutaneous PO2 from 65.4 and 47 to 69.7 and 52 Torr with increasing stability. The largest changes occurred in the first 6 mo of life. Maximum apnea duration (9.5 s, maximum 16 s), mean apnea duration (3.74 s, breathing pauses > or = 2 s), and time spent apneic per hour of irregular breathing (199 s/h) were not related to age. The comparison of data from siblings and controls showed similarities in the above-mentioned variables. No significant differences were found among the groups. Also a comparison of 30 pairs of siblings and controls, matched for age, gender, birth, and actual body weight, did not show significant differences. The present study extends the knowledge of development of breathing control beyond the first 6 mo of life.

Periodic Breathing in Infants With Near-Miss Sudden Infant Death Syndrome

PEDIATRICS ◽  
1979 ◽  
Vol 63 (3) ◽  
pp. 355-360
Author(s):  
Dorothy H. Kelly ◽  
Daniel C. Shannon
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Average Duration ◽  
Periodic Breathing ◽  
Sleep Time ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Significant Difference ◽  
Time Average

Twelve-hour nocturnal home recordings of respiration and heart rates were obtained during sleep in 32 infants with near-miss sudden infant death syndrome (SIDS) and in 32 control infants, and the recordings were analyzed for periodic breathing. An episode of periodic breathing was defined as three or more apneic pauses of three or more seconds. The duration of respirations interrupting the pauses was 20 seconds or less. Analysis revealed a statistically significant difference (P < .001) between the two groups, using criteria of percent of periodic breathing episodes, number of periodic breathing episodes/100 min of recorded sleep time, average duration of all episodes, and duration of the longest episode of periodic breathiflg. It is concluded that periodic breathing is present in excessive amounts during sleep in infants with near-miss sudden infant death svndrome.

Cardiorespiratory Function in 16 Full-Term Infants With Sudden Infant Death Syndrome

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 787-796
Author(s):  
D. P. Southall ◽  
J. M. Richards ◽  
V. Stebbens ◽  
A. J. Wilson ◽  
V. Taylor ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Matched Control ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Full Term ◽  
Sudden Infant ◽  
Breathing Patterns ◽  
Term Infants ◽  
Cardiorespiratory Function

Twenty-four-hour tape recordings of ECG and breathing movements from 16 term infants (≥37 weeks' gestation) who subsequently died of sudden infant death syndrome (SIDS) were compared with recordings from surviving infants from the same populations. Apneic pauses of varying durations, periodic and regular breathing patterns, heart and respiratory rates during regular breathing were measured. Only one of 16 full-term infants with SIDS had findings outside the range of age-matched control infants (an excess of periodic breathing patterns and an absence of regular breathing). When the first recordings of each of infants who died of SIDS, except one who had cyanotic episodes prior to death, were compared to recordings of survivors (six for each case) closely matched for age, gestation, and weight at birth, no differences in breathing patterns or heart or respiratory rates during regular breathing could be demonstrated. These particular measurements of cardiorespiratory function were, therefore, unable to identify the majority of full-term infants at risk for SIDS.

Respiratory Behavior in Near-Miss Sudden Infant Death Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 69 (6) ◽  
pp. 785-792
Author(s):  
Joan E. Hodgman ◽  
Toke Hoppenbrouwers ◽  
Susan Geidel ◽  
Anthony Hadeed ◽  
Maurice B. Sterman ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Sleep State ◽  
Apnea Duration ◽  
Prolonged Apnea ◽  
Respiratory Variables

Seventeen infants with unexplained prolonged apnea that has been designated near-miss sudden infant death syndrome were monitored for sleep and cardiorespiratory variables during a 12-hour, all-night recording session. Infants were matched for gestational age, sex, and age at recording with control infants. Respiratory variables studied included respiratory rate, respiratory variability, apnea duration, apnea density, and periodic breathing. No statistically significant differences were found in sleep state or respiratory variables between near-miss and control infants. Eight infants (47%) had no recurrence of prolonged apnea, whereas three (17.6%) had recurrent apneic episodes for six weeks to eight months following the original episode. No clinical or polygraphic finding predicted which infant would exhibit recurrent apnea. None of the infants was monitored at home. All infants were developing normally when examined at 1 to 2 years of age.

Periodic Breathing in Siblings of Sudden Infant Death Syndrome Victims

PEDIATRICS ◽  
1980 ◽  
Vol 66 (4) ◽  
pp. 515-520
Author(s):  
Dorothy H. Kelly ◽  
Alexander M. Walker ◽  
Lucienne Cahen ◽  
Daniel C. Shannon
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Gestational Age ◽  
Infant Death ◽  
Average Duration ◽  
Periodic Breathing ◽  
Sleep Time ◽  
Sudden Infant Death ◽  
Sudden Infant

To determine the incidence of periodic breathing (PB) episodes during sleep, 48 subsequent sudden infant death syndrome siblings and 48 control infants, matched by sex, gestational age, and chronologic age, were studied by home pneumogram technique. The sudden infant death syndrome siblings had a statistically significant increase in the percent of sleep time spent in PB, in the number of episodes/100 minutes of PB, in the longest episode of PB, and in the average duration of all episodes of PB. We conclude that PB is present in a higher amount in sudden infant death syndrome siblings as compared to control infants.

Periodic Breathing in Preterm Infants: Incidence and Characteristics

PEDIATRICS ◽  
1989 ◽  
Vol 84 (5) ◽  
pp. 785-792
Author(s):  
S. F. Glotzbach ◽  
R. B. Baldwin ◽  
N. E. Lederer ◽  
P. A. Tansey ◽  
R. L. Ariagno
Keyword(s):  
Preterm Infants ◽  
Age Groups ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Respiratory Pattern ◽  
Sudden Infant ◽  
Quiet Time ◽  
Term Infants ◽  
Respiratory Dysfunction ◽  
Postconceptional Age

The prevalence and characteristics of periodic breathing in preterm infants were measured by 24-hour impedance pneumograms in 66 preterm infants before discharge from the nursery. Four periodic breathing parameters (percentage of periodic breathing per quiet time, number of episodes of periodic breathing per 100 minutes of quiet time, mean duration of periodic breathing, and longest episode of periodic breathing) were compared to data available from healthy term infants and from term infants who subsequently died of sudden infant death syndrome (SIDS). Periodic breathing was found in all preterm infants studied and mean periodic breathing parameter values (12.0%, 8.6 episodes, 1.2 minutes, and 7.3 minutes, respectively) in our preterm population were substantially higher than values from healthy term infants and SIDS victims. Most periodic breathing parameters decreased significantly in infants studied at 39 to 41 weeks' postconceptional age compared with earlier postconceptional age groups. No relationship was found between central apneas of ≥15 seconds' duration and postconceptional age or any periodic breathing parameter. Periodic breathing is a common respiratory pattern in preterm infants that is usually not of pathologic significance. Associations between elevated levels of periodic breathing and respiratory dysfunction or SIDS should be made with caution.

Apnea, Hypoxemia, and Aborted Sudden Infant Death Syndrome

PEDIATRICS ◽  
1978 ◽  
Vol 62 (5) ◽  
pp. 686-691
Author(s):  
June P. Brady ◽  
Ronald L. Ariagno ◽  
John L. Watts ◽  
Steven L. Goldman ◽  
Fe M. Dumpit
Keyword(s):  
Heart Rate ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Total Duration ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Control Group ◽  
Sudden Infant ◽  
Nasal Catheter ◽  
End Tidal

To find out whether there is any relationship between the ventilatory response to hypoxia and the sudden infant death syndrome (SIDS), we studied the effects of mild induced hypoxia (PIO2, 120 mm Hg = 17% oxygen) in 16 infants aged 2 weeks to 6 months. Eight had recurrent apneic spells (apnea group) (five had aborted SIDS and three had recurrent apnea in the intensive care nursery) and eight were "well" preterm infants about to fly in a pressurized airplane (PIO2, 120 mm Hg) (control group). Mean birth weights were 2,245 and 1,400 gm and mean gestational ages were 35 and 30 weeks. Postconceptual ages (41.8 and 41.3 weeks) were almost identical. Heart rate was obtained from an ECG, and respiratory rate and pattern were obtained from a pneumogram. In addition, end-tidal PCO2 and PN2 or PO2 were obtained with a nasal catheter and gas analyzers. In the apnea group with inhalation of 17% oxygen, we observed an increase in periodic breathing and an increase in both rate and total duration of respiratory pauses. In the control group there were no significant changes. Heart rate and PCO2 did not change in either group. Our findings suggest that infants prone to apnea may have unique respiratory responses to mild induced hypoxia.

Mixed and Obstructive Sleep Apnea and Near Miss for Sudden Infant Death Syndrome: 2. Comparison of Near Miss and Normal Control Infants by Age

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 882-891 ◽  
Author(s):  
Christian Guilleminault ◽  
Ronald Ariagno ◽  
Rowena Korobkin ◽  
Lynn Nagel ◽  
Roger Baldwin ◽  
...  
Keyword(s):  
Normal Control ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Obstructive Apnea ◽  
Respiratory Events ◽  
Obstructive Sleep

Twenty-nine full-term near miss for sudden infant death syndrome (SIDS) and 30 normal control infants underwent 24-hour polygraphic monitoring. Several types of respiratory events during sleep (eg, central, mixed, and obstructive apnea, periodic breathing) were defined and tabulated. Analysis of these respiratory variables and comparison of groups of near miss and control infants indicated that between 3 weeks and 4½ months of age only one variable was consistently different at a statistically significant level: the number of mixed and obstructive apnea 3 seconds during total sleep time. This study also showed an increase in mixed and obstructive respiratory events during sleep at 6 weeks of age in control as well as in near miss infants.

Incidence of Apnea in Siblings of Sudden Infant Death Syndrome Victims Studied at Home

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 128-131
Author(s):  
Dorothy H. Kelly ◽  
Joseph Twanmoh ◽  
Daniel C. Shannon
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Chronic Hypoxia ◽  
Breathing Pattern ◽  
Respiratory Control ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Sibling Group

Victims of sudden infant death syndrome (SIDS) have been shown to have pathologic abnormalities consistent with chronic hypoxia.1-7 Two groups of infants at high risk of dying of SIDS, near miss infants and subsequent siblings of SIDS victims, have been studied in attempts to demonstrate physiologic abnormalities that could account for these pathologic findings. Investigators have found abnormalities in breathing pattern and the respiratory control system in the former consisting of prolonged sleep apnea, excessive short apnea, periodic breathing, hypoventilation, and depressed response to hypercarbia.8-13 However, studies in the SIDS sibling group have demonstrated varying results of excessive periodic breathing in the home14 and decreased apnea in the laboratory.15

scholarly journals Effects of environmental tobacco smoke on the health of children in the Syrian Arab Republic

1999 ◽  
Vol 5 (4) ◽  
pp. 690-697
Author(s):  
W. Maziak ◽  
F. Mzayek ◽  
M. Al Musherref
Keyword(s):  
Environmental Tobacco Smoke ◽  
Tobacco Smoke ◽  
Rural Areas ◽  
Sudden Infant Death ◽  
Cross Sectional Study ◽  
Respiratory Morbidity ◽  
Sudden Infant ◽  
Cross Sectional ◽  
Syrian Arab Republic ◽  
Urban And Rural Areas

In the Syrian Arab Republic, studies on the effects of environmental tobacco smoke on children are lacking. We conducted a cross-sectional study on the effect of household environmental tobacco smoke on 1859 children under 12 years from both urban and rural areas. Parental and household smoking were associated with respiratory morbidity in the children. Parental smoking was associated with an increased likelihood of having sudden infant death syndrome in the family and was also associated with the presence of other smokers within households, which adds to children’s exposure. To our knowledge this is the first study in the Syrian Arab Republic to report a clear association between environmental tobacco smoke and childhood respiratory morbidity

Estimation of dynamic chemoresponsiveness in wakefulness and non-rapid-eye-movement sleep

1995 ◽  
Vol 78 (3) ◽  
pp. 1052-1064 ◽  
Author(s):  
M. C. Khoo ◽  
F. Yang ◽  
J. J. Shin ◽  
P. R. Westbrook
Keyword(s):  
Simulated Data ◽  
Blood Gases ◽  
Periodic Breathing ◽  
Estimation Errors ◽  
Co2 Response ◽  
Ventilatory Responses ◽  
Single Breath ◽  
Stage 2 Sleep ◽  
Highly Correlated ◽  
Normal Adults

We developed a method for quantifying dynamic chemoresponsiveness on the basis of the ventilatory response to pseudorandom binary CO2 stimulation. The dynamic chemoreflex gain (GD) and effective time delay (TDeff) relating breath-to-breath fluctuations in alveolar PCO2 to ventilation were evaluated at frequencies between 0 and 0.05 Hz. Application of the method to simulated “data” showed that estimation errors in GD and TDeff were most likely to be minimized in the range of 0.01–0.03 Hz, corresponding to periodicities of 30–100 s. Estimation of TDeff was generally more susceptible to error than that of GD because of the limited time resolution of the breath-by-breath measurements. In eight awake normal adults, we compared estimates of GD derived from the pseudorandom binary CO2 stimulation test with peripheral and central hypercapnic sensitivities deduced from single-breath and Read rebreathing measurements in the same subject. GD at 0.02 Hz was highly correlated with peripheral hypercapnic sensitivity but poorly correlated with central hypercapnic sensitivity, underscoring the importance of the peripheral chemoreflexes in mediating ventilatory responses to phasic stimuli. Application of the procedure to a different group of 10 healthy volunteers during wakefulness and stage 2 sleep showed decreases in GD in 8 subjects but increases in 2 subjects. However, for the group as a whole, GD and TDeff did not change significantly between wakefulness and sleep. The proposed method may provide information more pertinent to periodic breathing than traditional CO2 response tests do, since the chemoreflex responses to phasic variations in blood gases are likely to be important in determining ventilatory control during sleep.

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