Document Detail

Responses to hypoxia and hypercapnia in infants of substance-abusing mothers.
MedLine Citation:
PMID:  1432417     Owner:  NLM     Status:  MEDLINE    
Because infants of substance-abusing mothers (ISAM) have an increased risk of sudden infant death syndrome and have abnormal sleeping ventilatory patterns, we studied the effects of mild hypoxia during quiet sleep on ventilatory pattern, heart rate, and arousal in 23 healthy ISAM (mean +/- SEM: 9.0 +/- 0.49 weeks of age) and 15 healthy, similarly aged, control infants. Hypercapnic challenges were performed in six ISAM and eight control subjects. Hypoxic arousal responses were elicited by rapidly decreasing inspired oxygen tension to 80 mm Hg for 3 minutes or until arousal occurred. Failure to arouse to hypoxia occurred in the majority of infants in both groups. All infants had a fall in end-tidal carbon dioxide tension during hypoxia, suggesting that each had a hypoxic ventilatory response. However, the fall in end-tidal carbon dioxide tension was significantly less in the ISAM (mean +/- SEM: -4.0 +/- 0.3 vs -8.0 +/- 1.0 mm Hg), suggesting blunted ventilatory responses to hypoxia. Periodic breathing occurred during 9.5% of hypoxic challenges in control infants compared with 37% in ISAM (p = 0.056). Heart rates were significantly higher in the ISAM before, during, and after hypoxic challenges. Hypercapnic challenges (inspired carbon dioxide tension of 60 mm Hg for a maximum of 3 minutes) resulted in arousal in all infants; however, ISAM required a significantly longer exposure to hypercapnia before arousal (mean +/- SEM; 116 +/- 7.8 vs 79 +/- 13.9 seconds; p < 0.02). We conclude that ISAM have an impaired repertoire of protective responses to hypoxia and hypercapnia during sleep, and that this may play a role in their increased risk for sudden infant death syndrome.
S L Ward; D B Bautista; M S Woo; M Chang; S Schuetz; L Wachsman; S Sehgal; X Bean
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The Journal of pediatrics     Volume:  121     ISSN:  0022-3476     ISO Abbreviation:  J. Pediatr.     Publication Date:  1992 Nov 
Date Detail:
Created Date:  1992-12-18     Completed Date:  1992-12-18     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  704-9     Citation Subset:  AIM; IM    
Division of Neonatology and Pediatric Pulmonology, Childrens Hospital Los Angeles, CA 90027.
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MeSH Terms
Anoxia / physiopathology*
Hypercapnia / physiopathology*
Pregnancy Complications*
Risk Factors
Substance-Related Disorders / complications*
Sudden Infant Death / etiology
Grant Support
1 RO1 HD22696-01A1/HD/NICHD NIH HHS; 2S07 RR05469-27/RR/NCRR NIH HHS

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