Quantitative and Qualitative Changes in Peripheral Chemoreceptor Activity in Preterm Infants
| Autor: | Daniel M. Mammel, John L. Carroll, Barbara B. Warner, Bradley A. Edwards, Dwayne L. Mann, Michael J. Wallendorf, Julie A. Hoffmann, Cameron M. Conklin, Harley Pyles, James S. Kemp |
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| Rok vydání: | 2023 |
| Předmět: | |
| Zdroj: | American Journal of Respiratory and Critical Care Medicine. 207:594-601 |
| ISSN: | 1535-4970 1073-449X |
| Popis: | Preterm infants are at risk for ventilatory control instability that may be due to aberrant peripheral chemoreceptor activity. While term infants have increasing peripheral chemoreceptor contribution to overall ventilatory drive with increasing postnatal age, how peripheral chemoreceptor contribution changes in preterm infants with increasing postmenstrual age is not known.To evaluate peripheral chemoreceptor activity between 32 and 52 weeks postmenstrual age in preterm infants, using both quantitative and qualitative measures.55 infants born between 24 weeks 0 days and 28 weeks 6 days gestation underwent hyperoxic testing at 1 to 4 time points between 32 and 52 weeks postmenstrual age. Quantitative minute ventilation decreases were calculated, and qualitative responses were categorized as apnea, continued breathing with a clear reduction in minute ventilation, sigh breaths, and no response.280 hyperoxic tests were analyzed (2.2 ± 0.3 tests per infant at each time point). Mean peripheral chemoreceptor contribution to ventilatory drive was 85.2 ± 20.0% at 32 weeks and 64.1 ± 22.0% at 52 weeks. Apneic responses were more frequent at earlier postmenstrual ages.Among preterm infants, the peripheral chemoreceptor contribution to ventilatory drive was greater at earlier postmenstrual ages. Apnea was a frequent response to hyperoxic testing at earlier postmenstrual ages, suggesting high peripheral chemoreceptor activity. A clearer description of how peripheral chemoreceptor activity changes over time in preterm infants may help explain how ventilatory control instability contributes to apnea and sleep-disordered breathing later in childhood. |
| Databáze: | OpenAIRE |
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