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Neuromodulatory Support for Breathing and Cardiovascular Action During Development
Ronald M Harper1, Kalpashri Kesavan2
1Department of Neurobiology and the Brain Research Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States.
Frontiers in Pediatrics
|October 18, 2021
Summary
Neonatal cardiorespiratory control is vital for survival. New neuromodulatory techniques offer promising support for breathing and cardiovascular function in infants with disrupted regulatory drives.
Area of Science:
- Neonatal physiology
- Developmental neuroscience
- Respiratory medicine
Background:
- Neonatal survival depends on precise cardiorespiratory control, which is vulnerable in premature infants.
- Disruptions in breathing and cardiovascular regulation, such as apnea of prematurity, can lead to severe injury or death.
- Altered breathing drives, influenced by temperature, chemical factors (CO2, O2), and sleep states (REM sleep), contribute to cardiorespiratory instability.
Purpose of the Study:
- To explore the challenges in neonatal cardiorespiratory regulation, particularly in premature infants.
- To evaluate the limitations of current support methods like positive pressure ventilation and caffeine.
- To investigate novel neuromodulatory approaches for supporting failing respiratory drives and compromised cardiovascular function.
Main Methods:
- Review of existing literature on neonatal cardiorespiratory control mechanisms.
- Analysis of the impact of prematurity, sleep states, and chemical drives on breathing regulation.
- Exploration of neuromodulatory interventions targeting the vestibular system and somatosensory pathways.
Main Results:
- Prematurity disrupts sensory and motor coordination, impacting breathing drives and cardiovascular responses.
- Current interventions like positive pressure ventilation and caffeine have potential long-term adverse effects.
- Neuromodulatory procedures show promise in stabilizing breathing and cardiovascular action by activating reflexive mechanisms.
Conclusions:
- There is a critical need for improved methods to support neonatal ventilation when regulatory drives fail.
- Neuromodulation, including vestibular and tactile/proprioceptive stimuli, offers a promising alternative for supporting cardiorespiratory function in neonates.
- These novel approaches can aid in managing central and obstructive apnea, periodic breathing, and associated cardiovascular instability during sleep.
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