Miller M J, DiFiore J M
Department of Pediatrics, Rainbow Babies and Childrens Hospital, Case Western Reserve University, Cleveland, Ohio 44106, USA.
Pediatr Res. 1995 Jun;37(6):796-9. doi: 10.1203/00006450-199506000-00020.
Periodic breathing and apnea are two forms of ventilatory instability which are commonly observed in premature infants. This study was undertaken to characterize the pattern of swallowing during apnea and compare this pattern to that present during breathing. We assessed the frequency and distribution of swallows during the respiratory pauses of apnea and periodic breathing in 22 premature infants birth weight 1.2 +/- 0.2 kg, postconceptional age 34 +/- 2 wk. Twelve infants had apnea and 10 exhibited periodic breathing. During sleep the pharyngeal phase of swallowing was detected by a catheter in the pharynx and esophageal peristalsis by an esophageal pressure catheter. Nasal airflow was monitored by a pneumotachometer. During apnea, the frequency of swallows was significantly greater than during the respiratory pauses of periodic breathing (15.9 +/- 8.2 versus 0.72 +/- 0.73 swallows/min, respectively, p < 0.0001) and also much higher than the rate of spontaneous swallows during sleep in either group (0.66 +/- 0.66 and 0.58 +/- 1.08 swallows/min, respectively). We conclude that an increased rate of swallowing is characteristic of apnea in premature infants, and distinguishes apnea from the respiratory pauses of periodic breathing.
周期性呼吸和呼吸暂停是早产儿中常见的两种通气不稳定形式。本研究旨在描述呼吸暂停期间的吞咽模式，并将其与呼吸期间的模式进行比较。我们评估了22名出生体重1.2±0.2 kg、孕龄34±2周的早产儿在呼吸暂停和周期性呼吸的呼吸暂停期间吞咽的频率和分布。12名婴儿有呼吸暂停，10名表现出周期性呼吸。在睡眠期间，通过咽部的导管检测吞咽的咽部阶段，并通过食管压力导管检测食管蠕动。通过呼吸流速计监测鼻气流。在呼吸暂停期间，吞咽频率明显高于周期性呼吸的呼吸暂停期间（分别为15.9±8.2次/分钟和0.72±0.73次/分钟，p<0.0001），也远高于两组睡眠期间的自发吞咽率（分别为0.66±0.66次/分钟和0.58±1.08次/分钟）。我们得出结论，吞咽频率增加是早产儿呼吸暂停的特征，可将呼吸暂停与周期性呼吸的呼吸暂停区分开来。
