Lehtonen Liisa, Martin Richard J
Department of Pediatrics, Turku University Hospital, Kiinamyllynkatu 4-8, 20520 Turku, Finland.
Semin Neonatol. 2004 Jun;9(3):229-38. doi: 10.1016/j.siny.2003.09.002.
This review will focus on the development of behavioural states and breathing during early developmental stages prior to term gestation. Although these behavioural states are immature during early development, their cyclicity is clearly seen. Preterm infants characteristically have a large proportion of indeterminate sleep and small amount of wakefulness. Whereas oxygenation is relatively stable during active and quiet sleep in ventilated preterm infants, indeterminate sleep and arousals are associated with hypoxaemic episodes. Arousals have also been linked to apnoea in spontaneously breathing infants. Since well-defined sleep cycles are beneficial for the oxygenation of preterm infants, we should explore ways to promote their natural sleep while they are exposed to neonatal intensive care. Care practices such as clustering procedures, kangaroo care and optimal positioning have been shown to improve the integrity of sleep. Optimizing the sleep cycling might improve the long-term outcome of preterm infants. More studies in this area are clearly needed.
本综述将聚焦于足月妊娠前早期发育阶段行为状态和呼吸的发展。尽管这些行为状态在早期发育过程中并不成熟，但其周期性清晰可见。早产儿的特点是不确定睡眠比例大，清醒时间少。在接受通气的早产儿中，主动睡眠和安静睡眠期间氧合相对稳定，而不确定睡眠和觉醒与低氧血症发作有关。觉醒也与自主呼吸婴儿的呼吸暂停有关。由于明确的睡眠周期有利于早产儿的氧合，我们应该探索在新生儿重症监护期间促进其自然睡眠的方法。诸如集中护理程序、袋鼠式护理和最佳体位等护理措施已被证明可改善睡眠的完整性。优化睡眠周期可能会改善早产儿的长期预后。显然需要在这一领域开展更多研究。
