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婴儿期胸廓对潮式呼吸贡献的变化。

Changes in the contribution of the rib cage to tidal breathing during infancy.

作者信息

Hershenson M B, Colin A A, Wohl M E, Stark A R

机构信息

Department of Anesthesia, Harvard Medical School, Boston, Massachusetts.

出版信息

Am Rev Respir Dis. 1990 Apr;141(4 Pt 1):922-5. doi: 10.1164/ajrccm/141.4_Pt_1.922.

Abstract

As the shape, compliance, and deformability of the rib cage (RC) change during infancy, RC participation in quiet breathing may increase. We used respiratory inductive plethysmography (RIP) to determine the relative contributions of the RC and abdomen (AB) to tidal volume (VT) in 20 studies in 14 healthy infants 1 to 26 months of age during quiet natural sleep. RIP was calibrated with simultaneous flow measurements (anesthesia mask and pneumotachograph) by the least squares method of statistical analysis. We analyzed segments of breathing with and without flow measurement for RIP-derived VT, change in RC volume (Vrc) and AB volume (Vab) with each breath and the RC contribution to tidal breathing (%RC = Vrc/Vrc + Vab). The %RC increased with age: %RC = 1.4 age (months) + 33 (r = 0.69, p less than 0.01). After 9 months of age, %RC resembled that found in quietly sleeping adolescents. Mask placement increased VT in all but one subject (mean increase, 29 +/- 23% of baseline +/- SD; p less than 0.001, paired t test). In infants younger than 10 months of age, mask placement also increased %RC (without mask, 40 +/- 9%; with mask, 46 +/- 10% p less than 0.02). We conclude that by 1 yr of age, the RC contribution to tidal breathing during quiet sleep is similar to that of the adolescent, suggesting that major developmental changes in RC shape, compliance, and deformability take place during infancy.

摘要

由于婴儿期胸廓(RC)的形状、顺应性和可变形性会发生变化,RC在安静呼吸中的参与度可能会增加。我们使用呼吸感应体积描记法(RIP)来确定14名1至26个月大的健康婴儿在安静自然睡眠期间,RC和腹部(AB)对潮气量(VT)的相对贡献。通过统计分析的最小二乘法,用同步流量测量(麻醉面罩和呼吸流速仪)对RIP进行校准。我们分析了有和没有流量测量的呼吸段,以获取RIP得出的VT、每次呼吸时RC体积(Vrc)和AB体积(Vab)的变化以及RC对潮气呼吸的贡献(%RC = Vrc / Vrc + Vab)。%RC随年龄增长而增加:%RC = 1.4×年龄(月)+ 33(r = 0.69,p小于0.01)。9个月龄后,%RC类似于安静睡眠青少年中的情况。除一名受试者外,面罩放置使所有受试者的VT增加(平均增加,为基线的29±23%±标准差;p小于0.001,配对t检验)。在10个月以下的婴儿中,面罩放置也增加了%RC(无面罩时,40±9%;有面罩时,46±10%,p小于0.02)。我们得出结论,到1岁时,RC在安静睡眠期间对潮气呼吸的贡献与青少年相似,这表明在婴儿期RC的形状、顺应性和可变形性发生了重大发育变化。

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