Anwar M, Marotta F, Fort M D, Mondestin H, Mojica C, Walsh S, Hiatt M, Hegyi T
Department of Pediatrics, UMDNJ-Robert Wood Johnson Medical School, St. Peter's Medical Center, New Brunswick 08903.
Early Hum Dev. 1993 Dec 31;35(3):183-92. doi: 10.1016/0378-3782(93)90105-4.
To examine the ventilatory response to inspired carbon dioxide in infants considered to be at risk for sudden infant death syndrome or apnea.
Clinical data measurement.
Infant apnea evaluation program of a university division of neonatology.
Fifty nine infants were full term characterized by the following diagnoses; siblings of infants who had died from sudden infant death syndrome (SIDS) (n = 7), apparent life threatening event (ALTE) (n = 24), apnea/cyanosis in the newborn nursery (n = 21), and controls. Sixty-nine infants were preterm and consisted of patients suffering from idiopathic apnea (n = 61), and bronchopulmonary dysplasia (n = 8).
The ventilatory response to carbon dioxide was measured with a computerized waveform analyzer.
Among full term infants no significant differences in the ventilatory slope in response to CO2 was seen. The range of mean slope was 19.4 +/- 7.6 in siblings of SIDS and 36 +/- 17 in control infants. Greater number of sibling of SIDS had slopes less than 20 ml/kg/min/mmHg in comparison to control infants. Sibling of SIDS had less increase in minute ventilation and inspiratory flow in response to CO2 administration in comparison to control infants. Preterm infants had similar slopes with a mean of 33 ml/kg/min/mmHg in infants with idiopathic apnea and 28 ml/kg/min/mmHg in infants with bronchopulmonary dysplasia.
The large intragroup variability in the ventilatory response to inspired CO2, confirming previously reported data, comprises the benefit of this test. Thus, ventilatory response to CO2 administration is not useful in unselected patients at risk of SIDS or apnea.
研究被认为有婴儿猝死综合征或呼吸暂停风险的婴儿对吸入二氧化碳的通气反应。
临床数据测量。
大学新生儿科的婴儿呼吸暂停评估项目。
59名足月儿，诊断如下：婴儿猝死综合征（SIDS）死亡婴儿的兄弟姐妹（n = 7）、明显危及生命事件（ALTE）（n = 24）、新生儿重症监护室的呼吸暂停/发绀（n = 21）以及对照组。69名早产儿，包括特发性呼吸暂停患者（n = 61）和支气管肺发育不良患者（n = 8）。
使用计算机化波形分析仪测量对二氧化碳的通气反应。
在足月儿中，未观察到对二氧化碳反应的通气斜率有显著差异。SIDS患儿兄弟姐妹的平均斜率范围为19.4±7.6，对照组婴儿为36±17。与对照组婴儿相比，更多SIDS患儿兄弟姐妹的斜率小于20 ml/kg/min/mmHg。与对照组婴儿相比，SIDS患儿兄弟姐妹在给予二氧化碳后分钟通气量和吸气流量的增加较少。早产儿的斜率相似，特发性呼吸暂停婴儿的平均斜率为33 ml/kg/min/mmHg，支气管肺发育不良婴儿为28 ml/kg/min/mmHg。
对吸入二氧化碳的通气反应存在较大的组内变异性，这证实了先前报道的数据，也说明了该测试的局限性。因此，对有SIDS或呼吸暂停风险的未筛选患者，给予二氧化碳后的通气反应并无用处。
