Developmental changes in upper airway dynamics
| Autor: | Lucila Bizari Fernandes do Prado, Eliot S. Katz, Cheryl A Black, Kathryn A. Carson, Carole L. Marcus, Patricia Galster, Janita Lutz |
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| Přispěvatelé: | Johns Hopkins Univ, Universidade Federal de São Paulo (UNIFESP) |
| Rok vydání: | 2004 |
| Předmět: |
Adult
Male Aging Adolescent Physiology Polysomnography Respiratory System Respiratory physiology Electromyography upper airway collapsibility Airway resistance Physiology (medical) medicine Humans Respiratory system Child Thoracic Wall Children critical pressure Air Pressure medicine.diagnostic_test infants Pulmonary Gas Exchange business.industry Airway Resistance sleep-disordered breathing Infant Carbon Dioxide Middle Aged respiratory system Respiration Artificial Respiratory Muscles respiratory tract diseases medicine.anatomical_structure Anesthesia Normal children Respiratory Mechanics Female Sleep Airway business Respiratory tract |
| Zdroj: | Repositório Institucional da UNIFESP Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
| ISSN: | 1522-1601 8750-7587 |
| DOI: | 10.1152/japplphysiol.00462.2003 |
| Popis: | Normal children have a less collapsible upper airway in response to subatmospheric pressure administration (P-NEG) during steep than normal adults do, and this upper airway response appears to be modulated by the central ventilatory drive. Children have a greater ventilatory drive than adults. We, therefore, hypothesized that children have increased neuromotor activation of their pharyngeal airway during sleep compared with adults. As infants have few obstructive apneas during steep, we hypothesized that infants would have an upper airway that was resistant to collapse. We, therefore, compared the upper airway pressure-flow (V) relationship during sleep between normal infants, prepubertal children, and adults. We evaluated the upper airway response to 1) intermittent, acute P-NEG (infants, children, and adults), and 2) hypercapnia (children and adults). We found that adults had a more collapsible upper airway during sleep than either infants or children. the children exhibited a vigorous response to both P-NEG and hypercapnia during sleep (P < 0.01), whereas adults had no significant change. Infants had an airway that was resistant to collapse and showed a very rapid response to P-NEG. We conclude that the upper airway is resistant to collapse during sleep in infants and children. Normal children have preservation of upper airway responses to P-NEG and hypercapnia during sleep, whereas responses are diminished in adults. Infants appear to have a different pattern of upper airway activation than older children. We speculate that the pharyngeal airway responses present in normal children are a compensatory response for a relatively narrow upper airway. Johns Hopkins Univ, Eudowood Div Pediat Resp Sci, Baltimore, MD 21287 USA Johns Hopkins Univ, Div Oncol Biostat, Baltimore, MD 21287 USA Universidade Federal de São Paulo, Escola Paulista Med, Dept Neurol & Internal Med, São Paulo, Brazil Universidade Federal de São Paulo, Escola Paulista Med, Dept Neurol & Internal Med, São Paulo, Brazil Web of Science |
| Databáze: | OpenAIRE |
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