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The effect of nasal obstruction in infancy and early childhood upon ventilation
Insights
Nasal obstruction in infants can cause abnormal breathing patterns during sleep, including periodic breathing or increased respiratory effort to maintain normal oxygen levels. Some infants experience decreased oxygen levels despite increased breathing effort.
Area of Science:
- Pediatric Pulmonology
- Sleep Medicine
- Respiratory Physiology
Background:
- Nasal obstruction is common in infants and young children.
- Its impact on sleep ventilation is not fully understood.
- Understanding these effects is crucial for infant respiratory health.
Purpose of the Study:
- To investigate the effects of mechanical nasal obstruction on ventilation during sleep in infants and young children.
- To characterize the ventilatory responses to nasal obstruction.
- To assess changes in esophageal pressure, tidal volume, and percutaneous oxygen tension.
Main Methods:
- Ten infants and young children underwent polygraphic recordings.
- Mechanical obstruction of the nostrils was performed during sleep.
- Measurements included esophageal pressure, tidal volume, and percutaneous oxygen tension (PO2).
Main Results:
- Three distinct ventilatory patterns were observed.
- Periodic breathing with alternating hypoventilation and hyperventilation occurred in 4 subjects, affecting PO2.
- Upper airway obstruction was compensated by increased respiratory effort in 5 subjects, maintaining normal PO2.
- One subject showed decreased tidal volume and PO2 despite increased respiratory effort.
Conclusions:
- Infants and young children exhibit varied responses to nasal obstruction during sleep.
- Some infants develop periodic breathing, while others increase respiratory effort to maintain oxygenation.
- Severe obstruction can lead to decreased oxygenation even with increased respiratory effort.
Abstract:
To evaluate the effect of nasal obstruction in infants and young children upon ventilation during sleep, change of ventilation was followed by polygraphic recordings of esophageal pressure, tidal volume and percutaneous oxygen tension when the nostrils were mechanically obstructed in 10 subjects; 3 types of ventilatory changes were noted. In 4 subjects periodic breathing appeared in which hypoventilation was alternated with occasional hyperventilation. Esophageal pressure, tidal volume and PO2 showed concomittant fluctuation. PO2 lowered during hypoventilatory phase was compensated by periodic hyperventilation. In 5 subjects upper airway obstruction was compensated for by increased respiratory endeavor and tidal volume and PO2 remained normal in spite of markedly increased esophageal pressure. In 1 subject tidal volume and PO2 remained decreased with marked increase of esophageal pressure. Largest airway obstruction was noted between the upper and the lower lips.