Hasan S U, Rigaux A
Department of Pediatrics, University of Calgary, Alberta, Canada.
Pediatr Res. 1992 Sep;32(3):342-9. doi: 10.1203/00006450-199209000-00020.
Mechanisms for the control of episodic fetal breathing movements or the onset of continuous breathing at birth remain unknown. Lung distension with 100% O2 at a continuous positive airway pressure of 30 cm H2O may induce arousal and continuous breathing. To investigate 1) the threshold range of arterial oxygen tension (PaO2) for the onset of arousal and breathing and 2) the graded response of breathing to various levels of PaO2, we studied 10 fetal sheep between 135 and 142 d of gestation (term = 147 +/- 2 d). Each fetus was instrumented to record sleep states, diaphragmatic electromyogram, arterial pH, and blood gas tensions. PaO2 threshold was determined through an indwelling O2 sensor catheter. Fetal lungs were distended at a continuous positive airway pressure of 40 cm H2O with 100% N2 or with O2 ranging from 40 to 100% via an in situ endotracheal tube. At the onset of arousal (n = 10), PaO2, arterial carbon dioxide tension, and Hb O2 saturation increased from control values of 21.7 +/- 0.75 torr (2.9 +/- 0.09 kPa), 41.8 +/- 1.1 torr (5.47 +/- 0.15 kPa), and 52.9 +/- 2.6% to 65.6 +/- 9.6 torr (8.74 +/- 1.28 kPa), 46.9 +/- 1.3 torr (6.25 +/- 0.17 kPa), and 92.9 +/- 2.06%, respectively, whereas the pH decreased from 7.31 +/- 0.006 to 7.27 +/- 0.009 (mean +/- SEM; p = 0.001, 0.04, 0.002, and 0.001, respectively). Seven of 10 fetuses breathed continuously. In these fetuses, PaO2 and arterial carbon dioxide tension further increased and pH decreased; however, no further significant increase in Hb O2 saturation was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
控制胎儿间歇性呼吸运动或出生时持续性呼吸开始的机制仍不清楚。在30厘米水柱的持续气道正压下用100%氧气使肺扩张可能会引起觉醒和持续性呼吸。为了研究1)觉醒和呼吸开始时动脉血氧张力(PaO2)的阈值范围,以及2)呼吸对不同水平PaO2的分级反应,我们研究了10只妊娠135至142天(足月=147±2天)的胎羊。每只胎儿都安装了仪器以记录睡眠状态、膈肌肌电图、动脉pH值和血气张力。通过留置的氧气传感器导管确定PaO2阈值。通过原位气管内导管,在40厘米水柱的持续气道正压下,用100%氮气或40%至100%的氧气使胎儿肺扩张。在觉醒开始时(n = 10),PaO2、动脉二氧化碳张力和血红蛋白氧饱和度分别从对照值21.7±0.75托(2.9±0.09千帕)、41.8±1.1托(5.47±0.15千帕)和52.9±2.6%增加到65.6±9.6托(8.74±1.28千帕)、46.9±1.3托(6.25±0.17千帕)和92.9±2.06%,而pH值从7.31±0.006降至7.27±0.009(平均值±标准误;p分别为0.001、0.04、0.002和0.001)。10只胎儿中有7只持续呼吸。在这些胎儿中,PaO2和动脉二氧化碳张力进一步升高,pH值降低;然而,血红蛋白氧饱和度没有进一步显著增加。(摘要截断于250字)