Kemp J S, Nelson V E, Thach B T
Edward Mallinckrodt Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, Missouri 63110.
Pediatr Res. 1994 Jul;36(1 Pt 1):7-11. doi: 10.1203/00006450-199407001-00002.
Soft bedding has been shown in epidemiologic studies to increase the risk for sudden, unexpected death in prone-sleeping infants. We compared the physical properties of conventional bedding to bedding from two sources: 1) bedding that covered the airways of victims of sudden infant death syndrome (SIDS) lying prone and face down at the time of death; and, 2) bedding associated with increased risk for SIDS in case-control studies (i.e. bedding filled with ti tree bark). Using simple mechanical models and the head from an infant mannequin, we measured the resistance to airflow, malleability, and capacity to limit CO2 dispersal of the bedding. We also describe a technique for quantifying bedding softness. The resistance and malleability were similar for the conventional bedding, the ti tree bedding, and the bedding from SIDS deaths (analysis of variance, p = 0.85 and 0.16). The ti tree bedding and the other bedding from SIDS cases differed from conventional bedding in two physical properties. Both groups were softer (p < or = 0.005) and limited CO2 dispersal to a greater degree (p < or = 0.009). The finding that increased capacity to limit CO2 dispersal is a consistent property of the bedding covering the airways of these SIDS victims and of bedding shown to be an epidemiologic risk factor for SIDS supports rebreathing of expired air as a mechanism underlying the association of certain kinds of bedding with SIDS.
流行病学研究表明，柔软的床上用品会增加俯卧睡眠婴儿突然意外死亡的风险。我们比较了传统床上用品与来自两个来源的床上用品的物理特性：1）覆盖婴儿猝死综合征（SIDS）受害者气道的床上用品，这些受害者在死亡时俯卧且面部朝下；2）在病例对照研究中与SIDS风险增加相关的床上用品（即填充茶树树皮的床上用品）。使用简单的力学模型和婴儿人体模型的头部，我们测量了床上用品对气流的阻力、柔韧性以及限制二氧化碳扩散的能力。我们还描述了一种量化床上用品柔软度的技术。传统床上用品、茶树床上用品和SIDS死亡案例中的床上用品的阻力和柔韧性相似（方差分析，p = 0.85和0.16）。茶树床上用品和其他SIDS案例中的床上用品在两个物理特性上与传统床上用品不同。两组都更柔软（p≤0.005），并且在更大程度上限制了二氧化碳的扩散（p≤0.009）。限制二氧化碳扩散能力增加是覆盖这些SIDS受害者气道的床上用品以及被证明是SIDS流行病学风险因素的床上用品的一个一致特性，这一发现支持呼出空气的再呼吸是某些类型床上用品与SIDS关联的潜在机制。
