Department of Pediatrics, Division of Neonatology, The Johns Hopkins School of Medicine, Baltimore, MD, USA.
Respir Physiol Neurobiol. 2013 Jan 1;185(1):120-31. doi: 10.1016/j.resp.2012.08.005. Epub 2012 Aug 10.
Breathing is a complex function that is dynamic, responsive, automatic and often unstable during early development. The carotid body senses dynamic changes in arterial oxygen and carbon dioxide tension and reflexly alters ventilation and plays an essential role in terminating apnea. The carotid body contributes 10-40% to baseline ventilation in newborns and has the greatest influence on breathing in premature infants who characteristically have unstable breathing leading to apnea of prematurity. In this review, we will discuss how both excessive and minimal contributions from the carotid body destabilizes breathing in premature infants and how exposures to hypoxia or infection can lead to changes in the sensitivity of the carotid body. We propose that inflammation/infection during a critical period of carotid body development causes acute and chronic changes in the carotid body contributing to a protracted course of intractable and severe apnea known to occur in a subset of premature infants.
呼吸是一个复杂的功能，在早期发育过程中是动态的、有反应的、自动的，而且常常不稳定。颈动脉体感知动脉血氧和二氧化碳张力的动态变化，并反射性地改变通气，在终止呼吸暂停中起着至关重要的作用。颈动脉体对新生儿的基础通气贡献 10-40%，对早产儿的呼吸影响最大，早产儿的呼吸特征是不稳定，导致早产儿呼吸暂停。在这篇综述中，我们将讨论颈动脉体过多和过少的贡献如何使早产儿的呼吸不稳定，以及缺氧或感染暴露如何导致颈动脉体敏感性的变化。我们提出，在颈动脉体发育的关键时期发生炎症/感染会导致颈动脉体的急性和慢性变化，导致一部分早产儿出现持续时间长、难以治疗和严重的呼吸暂停。
