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婴儿缺氧诱导觉醒前的通气反应:睡眠状态的影响

Ventilatory responses preceding hypoxia-induced arousal in infants: effects of sleep-state.

作者信息

Parslow Peter M, Harding Richard, Cranage Susan M, Adamson T Michael, Horne Rosemary S C

机构信息

Department of Paediatrics, Ritchie Centre for Baby Health Research, Monash University, Level 4, Monash Medical Centre, 246 Clayton Road, 3168, Vic., Clayton, Australia.

出版信息

Respir Physiol Neurobiol. 2003 Jul 16;136(2-3):235-47. doi: 10.1016/s1569-9048(03)00085-5.

Abstract

Augmented ventilation and/or arousal in response to hypoxia are important protective mechanisms during sleep. We aimed to quantify ventilatory responses preceding hypoxia-induced arousal in infants and determine the effects of sleep-state. Fifteen term infants were studied at 2-4 weeks, 2-3 and 5-6 months of age. Ventilatory responses to 15% oxygen inhalation were expressed as breath-by-breath changes from normoxic levels and averaged over 5, 10 and 15 breaths preceding arousal. Minute ventilation preceding arousal significantly increased above normoxic levels only in AS at 5-6 months. There were no sleep-state related differences in minute ventilation, oxygen saturation or carbon dioxide levels (expressed as changes from normoxic values) at 5, 10 or 15 breaths preceding arousal. However, the rate of oxygen desaturation during hypoxia in AS was two to four times faster than in QS at each age. We conclude that the ventilatory responses preceding hypoxia-induced arousal do not differ between sleep-states and that arousal occurs at similar levels of desaturation in both states.

摘要

睡眠期间,因低氧而增强的通气和/或觉醒是重要的保护机制。我们旨在量化婴儿低氧诱导觉醒前的通气反应,并确定睡眠状态的影响。对15名足月儿在2 - 4周、2 - 3个月和5 - 6个月时进行了研究。对吸入15%氧气的通气反应以相对于常氧水平的逐次呼吸变化表示,并在觉醒前的5次、10次和15次呼吸中进行平均。仅在5 - 6个月时的活跃睡眠中,觉醒前的分钟通气量显著高于常氧水平。在觉醒前的5次、10次或15次呼吸时,分钟通气量、氧饱和度或二氧化碳水平(以相对于常氧值的变化表示)不存在与睡眠状态相关的差异。然而,在每个年龄段,活跃睡眠中低氧期间的氧饱和度下降速率比安静睡眠快两到四倍。我们得出结论,低氧诱导觉醒前的通气反应在睡眠状态之间没有差异,并且在两种状态下,觉醒都发生在相似的去饱和水平。

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