Chiodini B A, Thach B T
Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri 63110.
J Pediatr. 1993 Nov;123(5):686-92. doi: 10.1016/s0022-3476(05)80841-8.
Although accidental suffocation has been suggested as a cause of sudden infant death syndrome in infants who are found prone with their faces straight down, the occurrence and effects on breathing of this position in living infants are unknown. We studied prone sleeping infants to see whether they will sleep with their faces straight down; whether they can spontaneously change from this position; the way that thermal stimuli or bedding softness influences this change; and whether rebreathing or airway obstruction occurs. We studied 11 healthy infants, aged 0.2 to 6 months, while they slept on soft and on firm bedding. Most infants slept facedown spontaneously or when turned to this position. All could turn their heads readily but slept facedown for variable periods. All infants put their faces straight down more often after cold than after warm stimuli. Obstructive apnea occurred only once, but rebreathing occurred in all subjects. When the infants were in the facedown position, inspired carbon dioxide was three times greater on soft than on hard bedding. End-tidal carbon dioxide partial pressure rose in all subjects while they were in the facedown position; in one infant, high end-tidal carbon dioxide partial pressure and desaturation occurred without signs of arousal. We conclude that infants sleeping facedown may occasionally have significant asphyxia; this sleep position may have a role in some infant deaths diagnosed as sudden infant death syndrome.
尽管有人提出，对于那些被发现脸朝下俯卧的婴儿，意外窒息是婴儿猝死综合征的一个原因，但这种姿势在存活婴儿中的发生情况及其对呼吸的影响尚不清楚。我们对俯卧睡眠的婴儿进行了研究，以观察他们是否会脸朝下睡觉；是否能自行从这个姿势改变；热刺激或被褥柔软度对这种改变的影响方式；以及是否会发生再呼吸或气道阻塞。我们研究了11名年龄在0.2至6个月的健康婴儿，观察他们在柔软和坚硬的被褥上睡眠时的情况。大多数婴儿会自发地脸朝下睡觉，或者在被翻成这个姿势时脸朝下睡觉。所有婴儿都能轻松转头，但脸朝下睡觉的时间各不相同。所有婴儿在受到冷刺激后比受到热刺激后更频繁地将脸直接朝下。阻塞性呼吸暂停仅发生过一次，但所有受试者都出现了再呼吸。当婴儿脸朝下时，在柔软被褥上吸入的二氧化碳比在坚硬被褥上多三倍。所有受试者脸朝下时呼气末二氧化碳分压都升高了；在一名婴儿中，出现了高呼气末二氧化碳分压和血氧饱和度下降，且没有觉醒迹象。我们得出结论，脸朝下睡觉的婴儿偶尔可能会出现严重窒息；这种睡眠姿势可能在一些被诊断为婴儿猝死综合征的婴儿死亡中起作用。
