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Periodic breathing and oxygen saturation in preterm infants at discharge
Nosrat M Razi1, Michelle DeLauter, Paresh B Pandit
1Division of Neonatology, Department of Pediatrics, The Children's Regional Hospital at Cooper Hospital and University Medical Center, Camden, NJ 08103, USA.
Insights
Periodic breathing (PB) is a common respiratory issue in preterm infants. This study found that PB frequently causes prolonged oxygen desaturation in these infants before hospital discharge.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Respiratory Physiology
Background:
- Periodic breathing (PB) is a prevalent respiratory pattern observed in preterm infants.
- Understanding factors influencing oxygenation is critical for preterm infant care before discharge.
Purpose of the Study:
- To investigate the impact of significant periodic breathing on oxygenation patterns in preterm infants nearing hospital discharge.
- To identify PB as a potential contributor to desaturation events in this vulnerable population.
Main Methods:
- Overnight polysomnography (12-hour recordings) was conducted in preterm infants (<= 34 weeks gestational age) prior to discharge.
- Included monitoring of arterial oxygen saturation (SpO2), respiratory effort, airflow, and heart rate.
- Analysis focused on 28 infants with significant PB (>= 5% of quiet time).
Main Results:
- All infants with significant PB experienced SpO2 drops of >= 5%.
- Most infants had SpO2 < 90% during PB.
- Thirty-one of 60 prolonged desaturations (SpO2 < 80% for >= 4 seconds) occurred during PB.
Conclusions:
- Periodic breathing is a significant cause of prolonged desaturation in preterm infants at the time of hospital discharge.
- These findings highlight the importance of monitoring and managing PB in preterm infants before they leave the hospital.
Objective:
Periodic breathing (PB) is a common respiratory pattern in preterm infants. Our aim was to determine the influence of PB on the pattern of oxygenation in preterm infants with significant PB at discharge from hospital.
Study Design:
Overnight 12-hour recordings of arterial O(2) saturation (SpO(2)), impedance breathing movement, nasal thermistor signals for airflow, and heart rate were performed in all preterm infants < or = 34 weeks' gestational age at birth, prior to hospital discharge. Infants had recovered from their neonatal complications and were not receiving methylxanthines or supplemental oxygen. Data from 28 infants who had significant PB (> or = 5% of quiet time artifact free) were further analyzed. Gestational age at birth was (median, range) 32 (27-34) weeks, and gestational age at recording was 35 (33-37) weeks.
Results:
The baseline SpO(2) was 98% (92-100%). During PB, all infants had episodes when SpO(2) fell > or = 5%, and all except one had episodes when SpO(2) was < 90%. Sixty episodes of prolonged desaturation (SpO(2) < or = 80% for >/ or = 4 seconds) were recorded in 10 infants: 31 occurred during PB, 16 during hypopnea, 10 during apnea, and 3 occurred in the absence of these breathing patterns. During PB, nine infants (32%) had 1 to 13 episodes of prolonged desaturation, lasting 9 (4-76) seconds.
Conclusion:
We conclude that PB is a common cause of prolonged desaturation in preterm infants at discharge.