Poets C F, Stebbens V A, Samuels M P, Southall D P
Department of Paediatric Pulmonology, Medizinische Hochschule, Hannover, Germany.
Pediatrics. 1993 Nov;92(5):686-90.
To obtain information on breathing patterns and oxygenation in children.
Overnight tape recordings of arterial oxygen saturation (SaO2; Nellcor N200 in beat-to-beat mode), photoplethysmographic waveforms, and breathing movements in 70 healthy children (mean age 8.0 years, range 2 through 16). Analysis of recordings for pauses in breathing movements of > or = 4 seconds (apneic pauses), for episodes in which SaO2 fell to < or = 90% (desaturations) and, only during the state of regular breathing, for baseline SaO2, heart rate, and respiratory rate.
Both baseline heart rate and respiratory rate decreased with increasing age (r = -.7 and -.3, respectively, P < .01). Baseline SaO2 was similar to that previously observed in infants (median 99.5%, range 95.8 to 100, 5th centile 96.6%). Every recording showed apneic pauses, with a frequency that did not vary consistently with age (median 7.7/h, range 0.6 to 25.5). One hundred nineteen apneic pauses in 43 recordings lasted for 15 to 19.9 seconds, and 23 lasted for > or = 20 seconds (longest 28.8 seconds). The number of episodic falls in SaO2 to < or = 90% decreased with age (r = -.3, P < .01); such episodes were found in 47% of children aged 2 through 6 years, but in only 13% of those aged 12 through 16 years. The 95th centile for desaturation frequency in the total group was 0.6/h. In six episodes in four patients, SaO2 fell to < or = 80%.
Apneic pauses, some of which can last for more than 20 seconds, are a normal phenomenon in healthy children and adolescents, but only a small minority of apneic pauses affect blood gas homeostasis. Information concerning oxygenation may be more relevant to our understanding of the maturation of respiratory control than the recording of breathing signals alone.
获取有关儿童呼吸模式和氧合作用的信息。
对70名健康儿童（平均年龄8.0岁，范围2至16岁）进行夜间动脉血氧饱和度（SaO2；采用逐搏模式的Nellcor N200）、光电容积脉搏波波形及呼吸运动的磁带记录。分析记录中呼吸运动暂停≥4秒（呼吸暂停）、SaO2降至≤90%的发作（血氧饱和度下降）情况，并且仅在规律呼吸状态下分析基线SaO2、心率和呼吸频率。
基线心率和呼吸频率均随年龄增长而下降（r分别为-0.7和-0.3，P<0.01）。基线SaO2与先前在婴儿中观察到的相似（中位数99.5%，范围95.8至100,第5百分位数96.6%）。每次记录均显示有呼吸暂停，其频率与年龄无一致变化（中位数7.7次/小时，范围0.6至25.5次/小时）。43份记录中的119次呼吸暂停持续15至19.9秒，23次持续≥20秒（最长28.8秒）。SaO2间歇性降至≤90% 的次数随年龄增长而减少（r=-0.3，P<0.01）；2至6岁儿童中有47%出现此类发作，但12至16岁儿童中仅13%出现此类发作。全组血氧饱和度下降频率的第95百分位数为0.6次/小时。4例患者的6次发作中，SaO2降至≤80%。
呼吸暂停，其中一些可持续20秒以上 在健康儿童和青少年中是正常现象，但只有少数呼吸暂停会影响血气稳态。与单独记录呼吸信号相比，有关氧合作用的信息可能与我们对呼吸控制成熟度的理解更相关。
