Abstract
In the neonate a decrease in lung volume accompanies the asynchronous(paradoxical)chest wall movement seen during active sleep. We sought to determine whether this would result in a decrease in arterial PO2 in view of the higher incidence of apnea in active as compared to quiet sleep. 10 healthy term infants were studied at a mean age of 39 hours(range 15-56 hrs) during both active (A.S.)and quiet sleep(Q.S.).We monitored transcutaneous PO2 continuously and recorded the timing and synchrony of chest wall movement during the respiratory cycle by means of mercury strain gauges placed over the upper chest wall and abdomen.Sleep state was determined from observation of body movement, respiratory variation,and electro-oculograms.
Strikingly in all 10 infants PO2 was consistently lower and more variable during A.S.(see table). During A.S. the upper chest wall moved asynchronously with respect to the abdomen 80% of the time.This never occurred during Q.S. These findings reveal a marked instability of arterial PO2 accompanying asynchronous movement of the upper chest wall in the healthy term neonate during A.S. The lower and more variable PO2 may be due to regional ventilation/perfusion inequalities. Apneic episodes (>5 sec)occurred in 5 of the infants,only during A.S.These findings may have important implications in our understanding of the higher incidence of apnea during A.S. in both preterm and term infants.
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Martin, R., Okken, A. 1204 DECREASED ARTERIAL OXYGEN TENSION ACCOMPANYING ASYNCHRONOUS CHEST WALL MOVEMENT IN ACTIVE SLEEP. Pediatr Res 12 (Suppl 4), 564 (1978). https://doi.org/10.1203/00006450-197804001-01210
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DOI: https://doi.org/10.1203/00006450-197804001-01210