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健康足月儿在两个产后年龄对吸入氧气逐次呼吸交替的呼吸反应。

The respiratory response of healthy term infants to breath-by-breath alternations in inspired oxygen at two postnatal ages.

作者信息

Calder N A, Williams B A, Kumar P, Hanson M A

机构信息

Department of Obstetrics and Gynaecology, University College Medical School, University College London, United Kingdom.

出版信息

Pediatr Res. 1994 Mar;35(3):321-4. doi: 10.1203/00006450-199403000-00008.

Abstract

We have studied the reflex respiratory responses to breath-by-breath alternations in fractional inspired oxygen in a group of healthy term infants at two ages, 43 +/- 7 h (study 1) and 47 +/- 3 d (study 2). Respiration was measured noninvasively using inductance plethysmography. Responses to alternations of fractional inspired oxygen between 0.16 and 0.21 (test runs) were compared with responses to alternating the inspired gas between two lines each containing a fractional inspired oxygen concentration of 0.21 (control runs). The respiratory response was measured as the mean percentage breath-by-breath alternation for inspiratory tidal volume (VTI), expiratory tidal volume (VTE), inspiratory time (TI), expiratory time (TE), frequency (f), mean inspiratory flow (VTI/TI), mean expiratory flow (VTE/TE), timing (TI.f), and ventilation. A significant chemoreflex response was present in the infants at the time of study 1, as shown by test runs that were significantly different from control for TI, TE, f, mean inspiratory flow, mean expiratory flow, timing, and ventilation (p < 0.05), and at study 2 for VTI, VTE, TE, f, mean inspiratory flow, mean expiratory flow, timing, and ventilation (p < 0.05). When control and test runs were compared separately with respect to age, there were no significant differences for any respiratory variable between study 1 and study 2. Thus, we did not observe significant maturation of respiratory chemoreflex responses to hypoxia after an age at which we could detect an established response, and this suggests that the "resetting" of chemoreceptor responses to hypoxia is essentially complete within approximately 24-48 h of birth in humans.

摘要

我们研究了一组健康足月儿在两个年龄段(43±7小时,研究1;47±3天,研究2)对每次呼吸时吸入氧分数交替变化的反射性呼吸反应。使用感应式体积描记法对呼吸进行无创测量。将吸入氧分数在0.16和0.21之间交替变化时的反应(测试运行)与在两条分别含有0.21吸入氧分数的线路之间交替吸入气体时的反应(对照运行)进行比较。呼吸反应通过吸气潮气量(VTI)、呼气潮气量(VTE)、吸气时间(TI)、呼气时间(TE)、频率(f)、平均吸气流量(VTI/TI)、平均呼气流量(VTE/TE)、时间(TI.f)和通气的每次呼吸交替变化的平均百分比来衡量。在研究1时,婴儿存在显著的化学反射反应,测试运行显示TI、TE、f平均吸气流量、平均呼气流量、时间和通气与对照有显著差异(p<0.05);在研究2时,VTI、VTE、TE、f、平均吸气流量、平均呼气流量、时间和通气也有显著差异(p<0.05)。当分别按年龄比较对照运行和测试运行时,研究1和研究2之间的任何呼吸变量均无显著差异。因此,在我们能够检测到已确立的反应的年龄之后,我们未观察到呼吸化学反射对低氧反应的显著成熟,这表明在人类出生后约24 - 48小时内,化学感受器对低氧反应的“重置”基本完成。

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