Claure Nelson, Tolosa Jose, Jain Deepak, Schott Alini, Aguilar Ana Cecilia, Dormishian Alaleh, Bancalari Eduardo
Division of Neonatology, Departments of Pediatrics, Miller School of Medicine, Miami, FL; Biomedical Engineering, College of Engineering, University of Miami, Miami, FL.
Division of Neonatology, Departments of Pediatrics, Miller School of Medicine, Miami, FL.
J Pediatr. 2025 Jun;281:114542. doi: 10.1016/j.jpeds.2025.114542. Epub 2025 Mar 14.
To evaluate the association between intermittent hypoxemia (IH) and hyperoxemia (HOX) during the first 28 days with peripheral and central chemoreception at 36 weeks of postmenstrual age among infants born extremely preterm.
For this observational study, 52 infants born at 23-28 weeks of gestational age were enrolled. Mean daily IH frequency (arterial oxygen saturation <80% for ≥10 seconds) and percent of time in HOX (arterial oxygen saturation ≥98% while the fraction of inspired oxygen was >0.21) were calculated for the first 28 days of life. At 36 weeks of postmenstrual age, respiratory control tests assessed peripheral chemoreception by ventilatory response to 100% O for 30 seconds in which decreased ventilation caused by inhibition of peripheral chemoreceptors reflects their contribution to respiratory drive. Central chemoreception was evaluated by ventilatory response to 4% inspired CO for 10 minutes.
Multivariable generalized linear models showed increasing IH and HOX were independently associated with an attenuated ventilatory response to 100% O at 36 weeks of postmenstrual age. IH and HOX were not significantly associated with an attenuated ventilatory response to CO.
In these infants born extremely preterm, neonatal IH and HOX were independently associated with attenuated peripheral chemoreception at near-term corrected age. This may reflect reduced peripheral chemoreceptor oxygen sensitivity and may be in part responsible for persistence of respiratory instability in infants born preterm. Neonatal IH or HOX were not associated with reduced central chemoreception.
评估极早产儿出生后28天内间歇性低氧血症（IH）和高氧血症（HOX）与月经龄36周时外周和中枢化学感受之间的关联。
在这项观察性研究中，纳入了52例孕23 - 28周出生的婴儿。计算出生后前28天的平均每日IH频率（动脉血氧饱和度<80%持续≥10秒）和HOX时间百分比（吸入氧分数>0.21时动脉血氧饱和度≥98%）。在月经龄36周时，通过对100%氧气通气30秒的通气反应评估外周化学感受的呼吸控制测试，其中外周化学感受器受抑制导致的通气减少反映了它们对呼吸驱动的作用。通过对4%吸入二氧化碳通气10分钟的通气反应评估中枢化学感受。
多变量广义线性模型显示，在月经龄36周时，IH和HOX增加与对100%氧气的通气反应减弱独立相关。IH和HOX与对二氧化碳的通气反应减弱无显著关联。
在这些极早产儿中，新生儿IH和HOX与近足月校正年龄时外周化学感受减弱独立相关。这可能反映外周化学感受器对氧的敏感性降低，可能部分导致早产儿呼吸不稳定持续存在。新生儿IH或HOX与中枢化学感受降低无关。
