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Effects of increase in body temperature on the breathing pattern in premature infants
D Berterottière1, A M D'Allest, M Dehan
1Laboratory of Physiology (INSERM CJF 8909), Hospital Antoine Béclère, Clamart, France.
Insights
A mild body temperature increase in premature infants significantly raises heart rate and respiratory frequency. This mild hyperthermia also increases periodic breathing during active sleep, indicating breathing pattern instability.
Area of Science:
- Neonatal Physiology
- Respiratory Control
Background:
- Premature infants often experience temperature instability.
- Understanding physiological responses to mild hyperthermia is crucial for neonatal care.
Purpose of the Study:
- To investigate the impact of a mild physiological increase in body temperature on respiratory patterns in healthy premature infants.
- To assess changes in respiratory frequency, heart rate, and specific respiratory events during normothermia and mild hyperthermia.
Main Methods:
- Seven healthy premature infants were polygraphically monitored during naps under two conditions: normothermia (rectal temp 36.9°C) and mild hyperthermia (rectal temp 37.7°C).
- Respiratory events, including central apnea, obstructive apnea, and periodic breathing, were analyzed for indices and duration during quiet and active sleep.
Main Results:
- Mild hyperthermia significantly increased respiratory frequency and heart rate (P < 0.05).
- No significant changes were observed in the indices or duration of central and obstructive apnea.
- Indices and duration of periodic breathing significantly increased during active sleep under hyperthermia (P < 0.05).
Conclusions:
- A mild increase in body temperature within the physiological range can enhance breathing pattern instability in premature infants, particularly during active sleep.
- These findings highlight the sensitivity of respiratory control to thermal changes in the neonatal period.
Abstract:
This study was designed to determine the effects of a mild increase in body temperature within the physiological range (0.8 degrees C) in healthy premature infants. Seven unsedated premature infants (38.4 wk +/- 1.5 postconceptional age) were monitored polygraphically during "morning naps" in an incubator under two different environmental temperatures: (1) normothermia with the incubator temperature set at 25 degrees C and the rectal temperature equal to 36.9 degrees C +/- 0.1; (2) hyperthermia with the incubator temperature set at 35 degrees C and the rectal temperature equal to 37.7 degrees C +/- 0.15. Respiratory frequency and heart rate, respiratory events, i.e., central and obstructive apnea, and periodic breathing with and without apneic oscillations were tabulated. Results for respiratory events were expressed as (1) indices of the total number of respiratory events, and of specific respiratory events per hour of total, quiet and active sleep times; (2) duration of total and specific respiratory events expressed as a percentage of total sleep, quiet and active sleep times. Respiratory frequency and heart rate were significantly increased by hyperthermia (P less than 0.05). Hyperthermia did not significantly modify the indices or the duration of central and obstructive apnea. But the indices and the duration of periodic breathing with and without apneic oscillations were significantly increased by hyperthermia during active sleep (P less than 0.05) but not during quiet sleep. The present study shows that a mild increase in body temperature within the physiological range in premature infants enhances the instability of the breathing pattern during active sleep.