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Prevalence and characterization of spontaneous oral breathing in preterm infants
V de Almeida1, R Alvaro, S al-Alaiyan
1University of Manitoba, Department of Pediatrics, Winnipeg, Canada.
Insights
Oral breathing in preterm infants is linked to body movements, particularly during sleep transitions. This finding is crucial for understanding infant respiratory patterns and defense mechanisms.
Area of Science:
- Neonatology
- Respiratory Physiology
- Infant Development
Background:
- Oral breathing is a defense mechanism, but its role in preterm infants is understudied.
- Previous research has not extensively explored the link between oral breathing and behavioral activities in this population.
Purpose of the Study:
- To investigate the prevalence of oral breathing in healthy preterm infants.
- To determine the relationship between oral breathing and specific behavioral activities, such as body movements and sleep states.
Main Methods:
- Studied ten healthy preterm infants (gestational age 29 weeks).
- Measured ventilation using a nose piece and flowmeter.
- Detected oral breathing via a carbon dioxide sampler and classified body movements by intensity (Type I and Type II).
Main Results:
- Oral breathing occurred 10% of the time, averaging 27 seconds per episode.
- 86% of oral breathing episodes were associated with Type II body movements (p < 0.01).
- Nasal ventilation decreased during movements when oral breathing was present (p = 0.017).
- Oral breathing prevalence varied significantly across sleep states, being highest in transitional and indeterminate sleep (50% and 35%, respectively).
Conclusions:
- Oral breathing in preterm infants is primarily associated with body movements, especially during more intense movements and specific sleep states.
- The findings suggest oral breathing is not rare but rather a responsive behavior in preterm infants.
- Further research is needed to fully elucidate the implications of oral breathing for infant respiratory health.
Abstract:
Oral breathing is an important defense mechanism, yet its prevalence and relationship to behavioral activities have not been studied in preterm infants. We tested the hypothesis that oral breathing is rare in these infants and likely to be restricted to periods of body movements. Ten healthy preterm infants (birthweight 1300 +/- 100 g [SE]; gestational age 29 +/- 1 weeks; postnatal age 36 +/- 7 days) were studied. Ventilation was measured with a nose piece and screen flowmeter. Oral breathing was detected with a carbon dioxide sampler at the mouth. Movements were classified according to intensity into type I (localized, minor signal distortion) and type II (generalized, moderate signal distortion). Oral breathing was present 10% of the time, with a mean duration of 27 +/- 3 seconds. Of 104 episodes of oral breathing, 13 (13%) occurred during type I movement, 89 (86%; p < 0.01) during type II, and 2 (2%) in the absence of movement. The delay from beginning of movements to the beginning of oral breathing was 20 +/- 3 seconds. Nasal minute ventilation decreased from 0.203 +/- 0.013 L.min-1.kg-1 during movements in the absence of oral breathing to 0.167 +/- 0.013 L.min-1.kg-1 during movements plus oral breathing (p = 0.017). In 496 type I and II movements, the prevalence of oral breathing was 21 of 165 (13%) in quiet sleep, 37 of 194 (19%) in rapid eye movement sleep, 6 of 12 (50%) in transitional sleep, and 44 of 125 (35%) in indeterminate sleep (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)