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Breathing, transcutaneous blood gases, and CO2 response in SIDS siblings and control infants during sleep
T Schäfer1, D Schäfer, M E Schläfke
1Department of Applied Physiology, Ruhr-University, Bochum, Federal Republic of Germany.
Insights
Infant breathing patterns and blood gases mature significantly in the first six months. Key breathing control responses, like CO2 response, remain stable in healthy infants up to 18 months.
Area of Science:
- Pediatric Pulmonology
- Neonatal Physiology
- Sleep Medicine
Background:
- Infant breathing control undergoes significant development in the first year of life.
- Understanding these changes is crucial for identifying potential risks and developmental abnormalities.
- Previous research has focused primarily on the first six months of life.
Purpose of the Study:
- To examine age-related changes in breathing patterns, transcutaneous blood gases, and CO2 response during sleep in infants up to 18 months.
- To compare these developmental patterns between healthy infants and siblings of sudden infant death syndrome (SIDS) victims.
- To extend the understanding of breathing control development beyond the initial six months of life.
Main Methods:
- Cross-sectional study involving 30 healthy control infants and 150 healthy siblings of SIDS victims.
- Whole-night sleep monitoring using noninvasive respiratory induction plethysmography and transcutaneous blood gas electrodes.
- Extensive screening to ensure all participants were healthy.
Main Results:
- Paradoxical breathing, periodic breathing, and respiratory rate decreased with age, while regular breathing and transcutaneous oxygen levels increased.
- These significant changes were most pronounced within the first six months of life.
- Transcutaneous PCO2, maximum PtcCO2, and ventilatory response to CO2 were not age-dependent. Apnea duration and frequency also showed no age relation.
Conclusions:
- Infant breathing patterns show substantial maturation in the first six months, with stabilization thereafter.
- Breathing control mechanisms, including CO2 response, appear stable beyond six months in healthy infants.
- No significant differences in breathing variables were observed between healthy infants and SIDS siblings, suggesting similar developmental trajectories.
Abstract:
Age-related changes of 20 variables describing breathing patterns, transcutaneous blood gases, and estimated CO2 response during sleep were examined in a cross-sectional study of 30 healthy control infants and 150 healthy siblings of sudden infant death syndrome victims within the first 18 mo of life. Whole-night measurements were performed using noninvasive respiratory induction plethysmography and transcutaneous blood gas electrodes. Each candidate for the study was extensively screened and found to be healthy. Mean transcutaneous PCO2 (PtcCO2, median 40.3 Torr) and maximum PtcCO2 (median 44.8 Torr), as well as the estimated ventilatory response to inhalation of 2% CO2 in air during regular breathing, causing a 20-36% increase of ventilation per Torr PtcCO2, were not related to postnatal age. In contrast, paradoxical breathing decreased from 49.5 to 0% of total sleep time (TST), periodic breathing from 5.5 to 0% TST, and respiratory rate during regular breathing from 40 to 22 breaths/min; the portion of regular breathing increased from 32 to 55% TST and mean and minimum transcutaneous PO2 from 65.4 and 47 to 69.7 and 52 Torr with increasing stability. The largest changes occurred in the first 6 mo of life. Maximum apnea duration (9.5 s, maximum 16 s), mean apnea duration (3.74 s, breathing pauses > or = 2 s), and time spent apneic per hour of irregular breathing (199 s/h) were not related to age. The comparison of data from siblings and controls showed similarities in the above-mentioned variables. No significant differences were found among the groups. Also a comparison of 30 pairs of siblings and controls, matched for age, gender, birth, and actual body weight, did not show significant differences. The present study extends the knowledge of development of breathing control beyond the first 6 mo of life.