Abstract
Although crying vital capacity has been recorded in infants recovering from RDS, little is known about physiological effects of vigorous crying at this stage of the illness. Detailed analysis of intraesophageal pressure (Pes) and abdominal & ortic blood pressure (B.P.) tracings were made on 15 patients recovering from RDS. Mean birth weight 2.04 kg (range 1.28-3.08), mean gestation 34 weeks (range 29-40) and mean age studied 63 hours (range 22-137). During crying maximum Pes ranged from -18.0 to -30.5 cm H2O during inspiration and from +6.2 to +34.3 during expiration. Pes remained positive during 66% of the respiratory cycle (range 54 to 85%) and mean Pes during inspiration was -12.3 cm H2O, during expiration mean Pes was +11.2 cm H2O. Heart rate rose significantly, mean increase 15 beats per minute (S.E.+3), P<0.01 and this was accompanied by a rise in B.P., mean systolic increase 5 mm Hg (S.E.±3), mean diastolic increase 9 mm Hg (S.E.±2) P<0.01. Beat to beat variation in B.P. during expiration resembled that seen in adults performing the Valsalva maneuver with sequential narrowing of the pulse pressure during successive heart beats. This study demonstrates the extreme range of intraoleural pressure generated and shows the significant effects of heart rate and blood pressure as a result of crying in patients recovering from RDS.
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Dinwiddie, R., Fox, W., Schwartz, J. et al. EFFECTS OF CRYING ON INTRATHORACIC PRESSURE AND ART ERIAL BLOOD PRESSURE IN INFANTS RECOVERING FROM RESPIRATORY DISTRESS SYNDROME (RDS). Pediatr Res 11, 569 (1977). https://doi.org/10.1203/00006450-197704000-01196
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DOI: https://doi.org/10.1203/00006450-197704000-01196