Page M, Jeffery H E
Department of Neonatal Medicine, Royal Prince Alfred Hospital, Sydney, Australia.
Pediatr Res. 1998 Nov;44(5):691-8. doi: 10.1203/00006450-199811000-00011.
This study was designed to evaluate upper airway protective mechanisms in response to pharyngeal fluid stimulation in healthy term and preterm infants at term equivalent age. Five term and seven preterm infants were studied and the following recorded: sleep state, cardiorespiratory function, and swallowing. Infusions of 0.9% saline and sterile water of volumes of 0.04, 0.2, and 0.35 mL were made during active (AS) and quiet sleep (QS). The effect of these variables on apnea (> or = 2 and > or = 5 s), swallowing, and arousal was examined. After pharyngeal infusion, apnea of > or = 2 and > or = 5 s did not change from spontaneous rates for both term and preterm infants. The most common response to pharyngeal infusion was swallowing. In AS, swallowing occurred after 65 and 73% and in QS after 40 and 64% of infusions in term and preterm infants, respectively. Swallowing was volume-related and occurred significantly more often in term infants after larger infusions of 0.35 and 0.2 mL (83 and 67%) compared with the 0.04 mL (19%) and after 0.2 mL compared with 0.04 mL for preterm infants (94 and 44%). At 0.2 mL, this was significantly higher in preterm compared with term infants (p < 0.01) and was the only significant difference between these infants. In response to pharyngeal fluid stimulation, airway defense in both full-term and preterm infants is maintained primarily by swallowing with no evidence of apnea.
本研究旨在评估足月健康婴儿和足月相当年龄的早产婴儿对咽部液体刺激的上呼吸道保护机制。研究了5名足月婴儿和7名早产婴儿，并记录了以下指标：睡眠状态、心肺功能和吞咽情况。在活跃睡眠（AS）和安静睡眠（QS）期间，分别注入0.04、0.2和0.35 mL的0.9%生理盐水和无菌水。研究了这些变量对呼吸暂停（≥2秒和≥5秒）、吞咽和觉醒的影响。咽部注入后，足月和早产婴儿≥2秒和≥5秒的呼吸暂停发生率与自发呼吸暂停发生率相比没有变化。咽部注入后最常见的反应是吞咽。在活跃睡眠中，足月和早产婴儿分别在65%和73%的注入后出现吞咽；在安静睡眠中，足月和早产婴儿分别在40%和64%的注入后出现吞咽。吞咽与注入量有关，足月婴儿在注入0.35 mL和0.2 mL后吞咽发生率显著高于注入0.04 mL后（分别为83%和67%）；早产婴儿在注入0.2 mL后吞咽发生率显著高于注入0.04 mL后（分别为94%和44%）。在注入0.2 mL时，早产婴儿的吞咽发生率显著高于足月婴儿（p<0.01），这是这两组婴儿之间唯一的显著差异。对咽部液体刺激的反应中，足月和早产婴儿的气道防御主要通过吞咽维持，且无呼吸暂停迹象。
