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Breathing patterns, oxygen and carbon dioxide levels in sleeping healthy infants during the first nine months after
E Horemuzova1, M Katz-Salamon, J Milerad
1Department of Woman and Child Health, Karolinska Institute, Stockholm, Sweden.
Insights
This study monitored breathing and oxygen levels in healthy infants up to 9 months old. Findings show normal oxygenation and carbon dioxide levels, with periodic breathing being a common pattern.
Area of Science:
- Neonatal Physiology
- Respiratory Medicine
- Pediatric Sleep Studies
Background:
- Understanding normal physiological parameters in infants is crucial for identifying potential health issues.
- Previous research has established baseline data for some respiratory variables, but comprehensive analysis across different sleep states and age ranges is ongoing.
- Arterial oxygen saturation (SaO2), transcutaneous PO2 (tcpO2), and pCO2 (tcpCO2) are key indicators of respiratory function in infants.
Purpose of the Study:
- To investigate arterial oxygen saturation (SaO2), transcutaneous PO2 (tcpO2), and pCO2 (tcpCO2) in sleeping healthy term infants during the first 9 months of life.
- To analyze breathing patterns, including periodic breathing (PB), in relation to age and sleep states (active sleep (AS), indeterminate sleep (IS), quiet sleep (QS)).
- To identify factors associated with hypoxemic episodes in this age group.
Main Methods:
- A cross-sectional study involving 44 healthy term infants (mean gestational age 40 weeks, mean birth weight 3520g).
- Measurements of SaO2, tcpO2, tcpCO2, heart rate (HR), and respiratory movements were recorded during natural nocturnal sleep.
- Data were stratified for sleep states (AS, IS, QS) and analyzed with respect to postnatal age.
Main Results:
- SaO2 and tcpO2 levels remained stable and comparable to older children across the study period.
- Transcutaneous carbon dioxide (tcpCO2) showed a significant postnatal decrease.
- Periodic breathing (PB) was observed in 38.6% of infants, and hypoxemic episodes (SaO2 < 90%) occurred in 11.3%, often linked to upper airway obstruction.
Conclusions:
- Oxygenation and carbon dioxide regulation in sleeping healthy term infants are mature and comparable to older children.
- Hypoxemic episodes in infants are primarily associated with upper airway obstruction.
- Periodic breathing is a normal finding in healthy term infants during the first 9 months of life, not necessarily indicative of pathology.
Unlabelled:
Data on arterial oxygen saturation (SaO2), transcutaneous PO2, pCO2 (tcpO2, tcpCO2) and breathing patterns in sleeping healthy term infants were obtained during the first 9 mo after birth. Forty-four healthy infants, mean GA at birth 40 +/- 1.0 wk, mean BW 3520 +/- 562 g were examined between 2 wk and 9 mo postnatally in a cross-sectional study. SaO2, tcpO2, tcpCO2, heart rate (HR), rib cage and abdominal respiratory movements were recorded during natural nocturnal sleep, stratified for sleep states (active sleep (AS), indeterminate sleep (IS), quiet sleep (QS)). The data on AS and IS were pooled as in previous studies. The variables were analysed with respect to age. SaO2 in AS + IS and QS was 96.1 +/- 1.3%, 96.6 +/- 1.4%, respectively. TcpO2 in AS + IS was 10.6 +/- 1.1 kPa and 10.7 +/- 1.3 kPa in QS, while tcpCO2 in AS + IS was 5.4 +/- 0.3 kPa and 5.4 +/- 0.4 kPa in QS. Neither SaO2 nor tcpO2 was influenced by age. TcpCO2 decreased significantly postnatally. Five infants (11.3%) experienced episodes of hypoxaemia with a mean decrease in SaO2 to 86 +/- 1.5%. In four infants these hypoxaemic episodes were linked to upper airway obstructions. Episodes of SaO2 < 90% in conjunction with a decrease in HR to < 100 bpm were detected in one infant only. Periodic breathing (PB) was observed in 38.6% of infants.
Conclusion:
Oxygenation and carbon dioxide levels in sleeping healthy term infants were comparable to those reported in older children. Hypoxaemic episodes, if present, are associated with upper airway obstruction. PB, often assumed to be a pathological feature, is a normal breathing pattern in this age group.
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