Document Detail

The relationship between bedding and face-down death in infancy: mathematical analysis of a respiratory simulation system using an infant mannequin to assess gas diffusibility in bedding.
MedLine Citation:
PMID:  16621385     Owner:  NLM     Status:  MEDLINE    
Rebreathing is a model for the relationship between a prone sleeping position and sudden infant death syndrome. This study used a mechanical simulation model to establish the relationship between types of bedding and rebreathing potential for an infant placed prone (face down) at different postnatal ages. The infant mannequin was connected to a respirator set to deliver physiologically appropriate combinations of tidal volume (V(T)) and respiratory rates (RR) across a range of postnatal ages (0-18 months). Before measurements were made, CO(2) flow was regulated to 5+/-0.1% of end-tidal PCO(2) (EtCO(2)). After the model was placed in a prone position, any increase in the fractional concentration of inspired CO(2) (FiCO(2)) was measured. FiCO(2) increased immediately and rapidly, and reached a maximum value within a few minutes. The maximum FiCO(2) ranged from under 2% to over 10%, depending on the bedding. FiCO(2) was also affected by V(T) and RR. This model is not applicable to actual infants because of the large tissue stores of CO(2) in infants; however, it is useful for evaluation of gas diffusibility of bedding and will simplify the investigation of sleeping environments when a baby is found dead with its face covered by soft bedding. In general, the higher the FiCO(2), the greater the rebreathing potential. Theoretically, considering the paucity of body stores of O(2), changes in FiO(2) would be affected not by changes in FiCO(2), but by CO(2) production and gas movement around the infant's face. The rapid decrease of FiO(2) is approximated at the inverse of the FiCO(2) timecourse, suggesting the significance of not only CO(2) accumulation but also O(2) deprivation in the potential space around the baby's face.
Jun Sakai; Masato Funayama; Jun Kanetake
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2006-04-18
Journal Detail:
Title:  Forensic science international     Volume:  166     ISSN:  0379-0738     ISO Abbreviation:  Forensic Sci. Int.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-02     Completed Date:  2007-04-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7902034     Medline TA:  Forensic Sci Int     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  14-20     Citation Subset:  IM    
Division of Forensic Medicine, Department of Public Health and Forensic Medicine, Tohoku University School of Medicine, 2-1 Seiryo-Machi, Sendai, Japan.
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MeSH Terms
Bedding and Linens / adverse effects*
Carbon Dioxide / blood
Child, Preschool
Infant, Newborn
Models, Theoretical
Oxygen / blood
Patient Simulation
Prone Position
Sudden Infant Death / blood,  etiology,  prevention & control*
Tidal Volume
Reg. No./Substance:
124-38-9/Carbon Dioxide; 7782-44-7/Oxygen

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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