Waggener T B, Southall D P, Scott L A
Floating Hospital for Infants and Children, New England Medical Center, Boston, Massachusetts 02111.
Pediatr Res. 1990 Feb;27(2):113-7. doi: 10.1203/00006450-199002000-00002.
Oscillatory patterns in ventilation have been seen in term and premature infants and are indicative of the stability of the respiratory blood gas feedback control system. Apneas are related to these patterns and apnea duration is correlated with pattern characteristics. In our study breathing patterns were analyzed in recordings from 10 term infants who subsequently died of sudden infant death syndrome (SIDS) and 10 control infants matched for birth wt, gestational age, and postnatal age. Subjects were drawn from a prospectively studied population of 9856 infants. Breath-by-breath minute ventilation was estimated in each of these 24-h recordings and oscillatory patterns were detected using a comb of digital bandpass filters. Confidence limits on the filter output and a bad data flag for rejection of data during gross body movements or crying insured that only significant patterns in ventilation were evaluated. Pattern prevalence and amplitude were compared in three frequency regimes: 6- to 87-s cycle times, 6- to 28-s cycle times, and 28- to 87-s cycle times. There was no significant difference between the SIDS and the control infants in any of these pattern comparisons (paired t and Wilcoxon paired rank sum tests, p less than 0.05). In light of the normal breathing patterns found in the SIDS infants, it is unlikely that susceptibility to SIDS is distinguished, at the time of these recordings, by instability of the respiratory blood gas feedback control system.
足月儿和早产儿都出现过通气振荡模式,这表明呼吸血气反馈控制系统的稳定性。呼吸暂停与这些模式相关,且呼吸暂停持续时间与模式特征相关。在我们的研究中,对10名随后死于婴儿猝死综合征(SIDS)的足月儿和10名在出生体重、胎龄和出生后年龄方面相匹配的对照婴儿的记录进行了呼吸模式分析。研究对象来自对9856名婴儿进行前瞻性研究的群体。在这些24小时的记录中,逐次呼吸估算分钟通气量,并使用数字带通滤波器梳检测振荡模式。滤波器输出的置信限以及用于在身体大幅运动或哭闹期间剔除数据的不良数据标记确保了仅对通气中的显著模式进行评估。在三个频率范围比较了模式发生率和振幅:周期时间为6至87秒、周期时间为6至28秒以及周期时间为28至87秒。在这些模式比较中,SIDS婴儿和对照婴儿之间均无显著差异(配对t检验和Wilcoxon配对秩和检验,p<0.05)。鉴于在SIDS婴儿中发现的正常呼吸模式,在这些记录时,SIDS易感性不太可能通过呼吸血气反馈控制系统的不稳定性来区分。