PEDIATRICS Vol. 75 No. 5 May 1985, pp. 848-854
This Article
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by van der Hal, A. L.
Right arrow Articles by Keens, T. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by van der Hal, A. L.
Right arrow Articles by Keens, T. G.

Hypoxic and Hypercapneic Arousal Responses and Prediction of Subsequent Apnea in Apnea of Infancy

Andre L. van der Hal MD1, Antonio M. Rodriguez MD1, Charles W. Sargent BS1, Arnold C. G. Platzker MD1, and Thomas G. Keens MD1

1 From the Neonatal-Respiratory Disease Division, Childrens Hospital of Los Angeles, and Department of Pediatrics, University of Southern California School of Medicine, Los Angeles

Hypoxic and hypercapneic arousal responses from quiet sleep were tested in 56 infants with apnea of infancy (one or more episodes of cyanosis, limpness, and apnea requiring vigorous stimulation or resuscitation with no treatable cause; age 6.8 ± 1.1 [SEM] months). Responses were compared with those of nine control infants ranging from 1 to 25 months of age. To assess hypercapneic arousal, the inspired Pco2 was rapidly increased during quiet sleep to 60 mm Hg or until arousal (restlessness, agitation, eye opening) occurred. All control infants and those with apnea of infancy aroused to hypercapnea, but control infants aroused at a lower inspired Pco2 (inspired Pco2 40.1 ± 2.6 mm Hg) than those with apnea of infancy (inspired Pco2, 46.9 ± 1.5 mm Hg, P < .05). To assess hypoxic arousal, the inspired Po2 was rapidly decreased during quiet sleep to 80 mm Hg or until arousal occurred. All control infants aroused to hypoxia (inspired Po2, 78.3 ± 2.1 mm Hg). However, only 38% of those with apnea of infancy aroused (inspired Po2 78.1 ± 0.8 mm Hg), indicating an abnormality in recognition of hypoxia, or central brainstem response to hypoxia. During the 10.4 ± 1.2 months of follow-up, there was a high incidence of subsequent apneas (greater than 20 seconds) during sleep at home in 50 apneic infants. Infants with abnormal hypoxic arousal responses had more severe subsequent apneas than those with normal hypoxic arousal responses (P < .05).

Key Words: hypoxia • hypercapnea • arousal • infant apnea

Submitted on May 15, 1984
Accepted on July 2, 1984




This article has been cited by other articles:


Home page
 J. Neurosci.Home page
Z.-G. Huang, K. J. S. Griffioen, X. Wang, O. Dergacheva, H. Kamendi, C. Gorini, E. Bouairi, and D. Mendelowitz
Differential Control of Central Cardiorespiratory Interactions by Hypercapnia and the Effect of Prenatal Nicotine
J. Neurosci., January 4, 2006; 26(1): 21 - 29.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
O. Hafstrom, J. Milerad, and H. W. Sundell
Prenatal Nicotine Exposure Blunts the Cardiorespiratory Response to Hypoxia in Lambs
Am. J. Respir. Crit. Care Med., December 15, 2002; 166(12): 1544 - 1549.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
C. L. MARCUS
Sleep-disordered Breathing in Children
Am. J. Respir. Crit. Care Med., July 1, 2001; 164(1): 16 - 30.
[Full Text] [PDF]

Home page
 PediatricsHome page
P. L. Carolan, W. B. Wheeler, J. D. Ross, and R. a. J. S. Kemp
Potential to Prevent Carbon Dioxide Rebreathing of Commercial Products Marketed to Reduce Sudden Infant Death Syndrome Risk
Pediatrics, April 1, 2000; 105(4): 774 - 779.
[Abstract] [Full Text]

Home page
 J. Appl. Physiol.Home page
C. L. Marcus, J. Lutz, J. L. Carroll, and O. Bamford
Arousal and ventilatory responses during sleep in children with obstructive sleep apnea
J Appl Physiol, June 1, 1998; 84(6): 1926 - 1936.
[Abstract] [Full Text] [PDF]

Home page
 CLIN PEDIATRHome page
A. Steinschneider, C. Richmond, V. Ramaswamy, and A. Curns
Clinical Characteristics of an Apparent Life-Threatening Event (ALTE) and the Subsequent Occurrence of Prolonged Apnea or Prolonged Bradycardia
Clinical Pediatrics, April 1, 1998; 37(4): 223 - 229.
[Abstract] [PDF]

Home page
 J. Appl. Physiol.Home page
A. S. Lijowska, N. W. Reed, B. A. M. Chiodini, and B. T. Thach
Sequential arousal and airway-defensive behavior of infants in asphyxial sleep environments
J Appl Physiol, July 1, 1997; 83(1): 219 - 228.
[Abstract] [Full Text] [PDF]