Kahraman Levent, Thach Bradley T
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, 660 S. Euclid, Campus Box 8208, St. Louis, MO 63110, USA.
J Appl Physiol (1985). 2004 Aug;97(2):669-74. doi: 10.1152/japplphysiol.00895.2003.
The physiological mechanisms that might be involved in an association between heat stress and sudden infant death syndrome (SIDS) are obscure. We tested the hypothesis that a combination of acute hypoxia and elevated body temperature (T(B)) might prevent autoresuscitation from hypoxic apnea (AR). We exposed 21-day-old mice (total = 216) to hyperthermia (40.5-43.5 degrees C), hypoxia, or a combination of the two. Neither hyperthermia alone (40.5-42.5 degrees C) nor hypoxia alone was found to be lethal, but the combination produced failure to AR during the first hypoxic exposure with increasing frequency as T(B) increased. The ability to withstand multiple hypoxic exposures was also reduced as T(B) increased. In contrast, heat stress causing moderate T(B) increase (40.5 degrees C) had no effect on survival. Increased T(B) (43.5 degrees C) reduced gasping duration and number of gasps. It increased heart rate during anoxia but did not alter gasping rate. Furthermore, the oxygen-independent increase in heart rate observed before gasping failure was usually delayed until after the last gasp in hyperthermic animals. Mild dehydration occurred during T(B) elevation, but this did not appear to be a primary factor in AR failure. We conclude that a thermal stress, which by itself is nonlethal, frequently prevents AR from hypoxic apnea. This may be due, at least in part, to decreased gasp number and duration as well as to hyperthermia-related asynchrony of reflexes regulating heart and gasping frequencies during attempted AR.
热应激与婴儿猝死综合征(SIDS)之间关联所涉及的生理机制尚不清楚。我们检验了这样一个假说:急性低氧与体温升高(T(B))相结合可能会阻止从低氧性呼吸暂停(AR)中自动复苏。我们将21日龄的小鼠(共216只)暴露于高热(40.5 - 43.5摄氏度)、低氧或两者的组合环境中。单独的高热(40.5 - 42.5摄氏度)或单独的低氧均未发现具有致死性,但两者结合会导致在首次低氧暴露期间无法自动复苏,且随着T(B)升高,这种情况出现的频率增加。随着T(B)升高,耐受多次低氧暴露的能力也会降低。相比之下,引起T(B)适度升高(40.5摄氏度)的热应激对存活率没有影响。T(B)升高(43.5摄氏度)会缩短喘息持续时间和喘息次数。它会在缺氧期间增加心率,但不会改变喘息频率。此外,在喘息失败前观察到的与氧气无关的心率增加,在高热动物中通常会延迟到最后一次喘息之后。在T(B)升高期间会出现轻度脱水,但这似乎不是自动复苏失败的主要因素。我们得出结论,本身无致死性的热应激常常会阻止从低氧性呼吸暂停中自动复苏。这可能至少部分是由于喘息次数和持续时间减少,以及在尝试自动复苏期间与高热相关的调节心脏和喘息频率的反射不同步所致。