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The morphology of periodic breathing in infants and adults
Z Weintraub1, D Cates, K Kwiatkowski
1Carmel Medical Center, Neonatal Department, Technion, Israel Institute of Technology, Haifa, Israel.
Insights
Periodic breathing patterns differ significantly between preterm infants and adults. Infants exhibit a crescendo-decrescendo pattern, while adults show a predominantly decrescendo pattern, indicating developmental changes in respiratory control.
Area of Science:
- Physiology
- Neonatology
- Pulmonology
Background:
- Periodic breathing is a common respiratory pattern in infants, particularly preterm infants.
- The morphology of periodic breathing patterns may change with age and development.
- Understanding these changes is crucial for assessing respiratory health in different age groups.
Purpose of the Study:
- To investigate the hypothesis that the crescendo-decrescendo pattern of periodic breathing is more prevalent in infants than adults.
- To compare the morphologies of periodic breathing across different age groups, from preterm infants to adults.
Main Methods:
- Respiratory pattern and ventilation were measured using a flow-through system in four groups: preterm infants (2 groups), full-term infants, and adults.
- Breathing morphologies were classified based on respiratory flow characteristics.
- Analysis included total breathing cycle duration, phase durations, breaths per interval, and duty cycle.
Main Results:
- Preterm infants predominantly displayed a crescendo-decrescendo breathing pattern (>50%).
- Adults showed a shift towards a predominant decrescendo breathing pattern (50%).
- Breathing cycle duration nearly doubled in adults compared to neonates, while the duty cycle remained consistent.
Conclusions:
- The findings suggest a developmental shift in the respiratory control system's strategy for periodic breathing from infancy to adulthood.
- This change may be influenced by mechanical and chemoreceptor limitations present in early life.
- The transition from a crescendo-decrescendo to a decrescendo pattern highlights adaptive changes in respiratory regulation with maturation.
Abstract:
To test the hypothesis that the crescendo-decrescendo type of pattern of periodic breathing is more common in infants than in adulthood, we examined the morphologies of periodic breathing in four groups of subjects: group 1 (n=10, gestational age 30+/-1 week), group 2 (n=10, GA 31+/-1 week), group 3 (n=10, GA 38+/-1 week), and group 4 (n=10, age 50+/-4 years). Respiratory pattern and ventilation were measured using a flow-through system. The breathing morphologies were defined according to the respiratory flow. We found (1) a predominant crescendo-decrescendo pattern in preterm infants (groups 1 and 2, >50%) and this changed to a predominant decrescendo breathing in adults (group 4, 50%); (2) total breathing cycle and its phases did not change significantly among the neonatal groups, but they almost doubled in adult subjects; however, the number of breaths per breathing interval remained the same (crescendo-decrescendo) or less (flat and decrescendo) in adults as compared to preterm infants; (3) the duty cycle (breathing interval/cycle duration) remained consistent with age; and (4) at the beginning of each breathing interval, alveolar P(CO2) was highest and alveolar P(O2) and O2 saturation lowest. The findings suggest a change in the strategy of the respiratory control system during periodic breathing between the infant and the adult, perhaps dictated by mechanical and chemoreceptor limitations early in age, with a switch from a crescendo-decrescendo to a predominantly decrescendo pattern.
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