Poets C F, Southall D P
Department of Paediatrics, National Heart and Lung Institute, London, U.K.
Early Hum Dev. 1991 Jul;26(1):1-12. doi: 10.1016/0378-3782(91)90038-5.
The characteristics of the arterial oxygen saturation (SaO2) signal during episodes of hypoxaemia (SaO2 less than or equal to 80% for greater than or equal to 4 s) associated with periodic and non-periodic apnoeic pauses were studied in 16 preterm infants with cyanotic episodes (patients). and 15 asymptomatic preterm infants (controls), matched on birthweight and gestational age. The patients showed a significantly higher percentage of apnoeic pauses followed by a hypoxaemic episode (25 vs. 6%, P less than 0.01), and a two-fold increase in the slope of the desaturation curve (8.4 vs. 4.3% per s, P less than 0.005) in periodic compared with non-periodic breathing. All other characteristic of oxygenation (baseline SaO2 before episodes of hypoxaemia, delay between onset of apnoeic pause and onset of desaturation, lowest SaO2 during episodes of hypoxaemia) were similar for periodic and non-periodic breathing patterns. Similar, but not significant, differences between isolated and periodic apnoeic pauses were also present in the controls. An analysis of episodes of bradycardia (less than or equal to 100 beats per minute (bpm] showed that out of 121 episodes in the patients 118 were accompanied by a fall in SaO2 to less than or equal to 80%, and in the remaining three SaO2 fell to 82%, 85% and 86%, respectively. Thus all episodes of bradycardia (less than or equal to 100 bpm) were associated with a fall in SaO2 detected by beat-to-beat pulse oximetry. Examination of hypoxaemic episodes and their relationship with bradycardia and with apnoeic pauses, periodic and non-periodic, may help the further understanding of the control of arterial oxygenation in preterm infants with cyanotic episodes.
对16名有发绀发作的早产婴儿（患者）和15名出生体重及胎龄匹配的无症状早产婴儿（对照），研究了与周期性和非周期性呼吸暂停相关的低氧血症发作期间（动脉血氧饱和度（SaO2）信号低于或等于80%且持续时间大于或等于4秒）的特征。患者出现呼吸暂停后伴有低氧血症发作的比例显著更高（25%对6%，P<0.01），与非周期性呼吸相比，周期性呼吸时去饱和曲线的斜率增加了两倍（8.4%每秒对4.3%每秒，P<0.005）。周期性和非周期性呼吸模式下，所有其他氧合特征（低氧血症发作前的基线SaO2、呼吸暂停开始至去饱和开始的延迟、低氧血症发作期间的最低SaO2）相似。对照中孤立性和周期性呼吸暂停之间也存在类似但不显著的差异。对心动过缓发作（每分钟小于或等于100次心跳（bpm））的分析表明，患者的121次发作中有118次伴有SaO2降至小于或等于80%，其余3次中SaO2分别降至82%、85%和86%。因此，所有心动过缓发作（每分钟小于或等于100次bpm）均与逐搏脉搏血氧测定法检测到的SaO2下降相关。检查低氧血症发作及其与心动过缓和呼吸暂停（周期性和非周期性）的关系，可能有助于进一步了解有发绀发作的早产婴儿动脉氧合的控制情况。
