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Small preterm infants (less than or equal to 1500 g) have only a sustained decrease in ventilation in response to

R Alvaro1, J Alvarez, K Kwiatkowski

  • 1Department of Pediatrics, University of Manitoba, Winnipeg, Canada.

Pediatric Research
|October 1, 1992
PubMed
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Smaller preterm infants (<=1500g) show a blunted ventilatory response to low oxygen (15% O2), unlike larger infants. This suggests their respiratory control is more fetal-like, with no initial breathing increase during hypoxia.

Area of Science:

  • Neonatal Physiology
  • Respiratory Control

Background:

  • The classic biphasic ventilatory response to hypoxia (15% O2) was previously observed in larger preterm infants.
  • Current neonatal intensive care units (NICUs) manage smaller preterm infants (<=1500g) who may exhibit different physiological responses.

Purpose of the Study:

  • To investigate the ventilatory response to 15% oxygen in smaller preterm infants (<=1500g).
  • To test the hypothesis that smaller preterm infants exhibit a fetal-like respiratory response, characterized by an absence of initial hyperventilation.

Main Methods:

  • Studied 14 healthy preterm infants (<=1500g) during rapid eye movement (REM) and quiet sleep.
  • Measured ventilation using a nosepiece and flow-through system.
  • Defined sleep states using EEG, electro-oculogram, and body movements; infants breathed 15% O2 for 5 min after a 3-min control period in 21% O2.

Related Experiment Videos

Main Results:

  • In REM sleep, minute ventilation significantly decreased from control values after 1 minute of 15% O2 exposure (p=0.03) and continued to decrease through 5 minutes (p=0.004).
  • In quiet sleep, minute ventilation also significantly decreased from control values after 3 minutes of 15% O2 exposure (p=0.03) and remained decreased at 5 minutes (p=0.04).
  • No initial increase in ventilation was observed in either sleep state, supporting the fetal-like response hypothesis.

Conclusions:

  • Healthy preterm infants weighing <=1500g demonstrate a depressed ventilatory response to acute hypoxia (15% O2).
  • This response pattern, lacking an initial hyperventilatory phase, is consistent with a more immature or fetal-like respiratory control system in smaller preterm infants.