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Response to external obstruction in preterm infants with apnea
C J Upton1, A D Milner, G M Stokes
1Department of Neonatal Medicine, City Hospital, Nottingham, United Kingdom.
Pediatric Pulmonology
|December 1, 1992
Summary
External airway obstruction triggers apnea in preterm infants. This response, particularly post-obstruction apnea, correlates with spontaneous apnea frequency and changes over time in the neonatal period.
Area of Science:
- Neonatal Physiology
- Respiratory Control
Background:
- Preterm infants are susceptible to apnea.
- External airway obstruction can elicit apneic responses in neonates.
Purpose of the Study:
- To investigate the time course of apneic responses to airway obstruction in preterm infants.
- To determine the relationship between obstruction-induced apnea and spontaneous apnea occurrence.
Main Methods:
- Studied 23 preterm infants (median birthweight 1.14 kg, gestation 29 weeks).
- Measured upper airway flow using a face mask and pneumotachograph.
- Intermittently applied external airway obstruction and analyzed 380 occlusions for apneic events.
Main Results:
- Apnea occurred during obstruction in 19% and after obstruction in 32% of occasions.
- Obstruction-induced apnea was significantly more frequent than pre-obstruction apnea (8%).
- An obstruction score, reflecting apnea frequency, positively correlated with spontaneous apnea and peaked between days 15-28 of postnatal life.
Conclusions:
- External airway obstruction is a significant trigger for apnea in a proportion of preterm infants.
- The temporal pattern of obstruction-induced apnea may reflect the natural course of apnea in susceptible neonates.