Kwon Dong Rak, Park Gi Young, Jeong Ji Eun, Kim Woo Taek, Lee Eun Joo
Department of Rehabilitation Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Department of Pediatrics, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine, Daegu, Korea.
Korean J Pediatr. 2018 Mar;61(3):78-83. doi: 10.3345/kjp.2018.61.3.78. Epub 2018 Mar 19.
Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables.
Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-squre (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated.
The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants.
This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.
早产儿由于吸吮 - 吞咽 - 呼吸不协调不成熟而频繁出现的血氧饱和度下降会影响心脏、肺和大脑等多个器官，进而影响生长发育。在早产儿中最显著的是，喂养时的血氧饱和度下降甚至可能影响鼻饲喂养期间的肺功能。由于呼吸肌活动可能反映呼吸过程中所需的功，我们评估了有喂养时血氧饱和度下降的足月儿和早产儿在这些活动上的差异，并研究了其与临床变量的相关性。
评估了19例有喂养时血氧饱和度下降的早产儿（第1组）和19例年龄匹配的足月儿（第2组）。使用视频记录评估口面部运动功能。计算肌电图信号的均方根（RMS）包络以量化参与呼吸的肌肉活动。评估两组之间RMS的差异以及与包括胎龄（GA）、出生体重（BW）和出生后1分钟及5分钟时的阿氏评分（AS）在内的临床变量的相关性。
与第2组相比，第1组的膈肌RMS值（RMS - D）和腹直肌RMS值（RMS - R）显著更高，且第1组的1分钟和5分钟阿氏评分显著低于第2组。在所有婴儿中，RMS - D和RMS - R与GA、BW、1分钟和5分钟阿氏评分呈负相关。
本研究表明，与足月儿相比，早产儿在喂养期间呼吸肌活动增强。此外，呼吸肌活动与所有临床变量呈负相关。
