Abstract
Periodic breathing in infancy represent an abnormal breathing pattern often associated with prolonged apnea. Although the etiology of periodic breathing is not well-established, it most likely represents an immaturity of respiratory control. In order to determine if endogenous endorphorins and enkephalins affected periodic breathing, a group of infants who presented with markedly excessive periodic breathing were studied and treated with naloxone, a narcotic antagonist. Eight infants comprised the study population. Mean BW was 2.2 ± 0.3 SEM kg (R = 1.0 - 3.2 kg), mean GA was 33.8 ± 15 SEM wks (R = 30-40 wks). Mean age at initial study was 17.2 ± 6.0 SEM days (R = 7-56 days). Initial study consisted of a 6 hour thermistor-pneumocardiogram. If periodic breathing greater than 15% of sleep time was detected, an IV was inserted and an additional 24 hours of recording were performed on the following day to determine baseline level of periodic breathing. Infants were then treated with IV naloxone .01 mgm/kg/dose q 4 hrs for 48 hrs. Respiration and heart rate were recorded continuously throughout this period and for 48 hours following discontinuation of naloxone. Baseline level of periodic breathing for infants was 34.4% ± 3.3% SEM of sleep. Naloxone decreased periodic breathing to 15.1% ± 3.8% SEM of sleep, a mean decrease of 57.1% ± 11.1% SEM (p<.01). Following discontinuation of naloxone, periodic breathing remained at a lower level than baseline-16.3% ± 3.8 SEM, a mean decrease of 50.2% ± 10.6 SEM (p <.01). No side effects were noted during the study. Follow-up of infants monthly after discharge demonstrated continuing reduction in the amount of periodic breathing. These data suggest that naloxone significantly decreases periodic breathing.
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Spitzer, A., Juliano, P., Peeke, K. et al. NALOXONE SIGNIFICANTLY DECREASES PERIODIC BREATHING OF INFANCY. Pediatr Res 18 (Suppl 4), 349 (1984). https://doi.org/10.1203/00006450-198404001-01536
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DOI: https://doi.org/10.1203/00006450-198404001-01536