PEDIATRICS Vol. 78 No. 1 July 1986, pp. 44-50
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
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 Ward, S. L. D.
Right arrow Articles by Keens, T. G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ward, S. L. D.
Right arrow Articles by Keens, T. G.

Absent Hypoxic and Hypercapneic Arousal Responses in Children With Myelomeningocele and Apnea

Sally L. Davidson Ward MD1, Bruce G. Nickerson MD1, Andre van der Hal MD1, Antonio M. Rodriguez MD1, Robert A. Jacobs MD1, and Thomas G. Keens MD1

1 From the Childrens Hospital of Los Angeles and University of Southern California School of Medicine, Los Angeles

Hypoxic and hypercapneic arousal responses from quiet sleep were tested in seven infants with myelomeningocele and Arnold-Chiari malformation who were symptomatic with apnea and/or hypoventilation. All infants with myelomeningocele required tracheostomy and posterior fossa decompression. Responses were compared with those of nine healthy control infants. To assess hypoxic arousal, inspired Po2 was decreased until the end-tidal (alveolar) Po2 reached 45 mm Hg for a maximum of three minutes. Eleven studies were performed in seven infants with myelomeningocele, and arousal occurred in only two studies (18.2%). Eight of nine control infants aroused to hypoxia (89%). To test hypercapneic arousal, inspired Pco2 was increased until end-tidal Pco2 reached 60 mm Hg for a maximum of three minutes. Eight studies were performed on six infants with myelomeningocele, and arousal occurred in three studies (37.5%). All seven control infants studied aroused to hypercapnea (100%). Three infants with myelomeningocele subsequently died. Infants with myelomeningocele, Arnold-Chiari malformation, and apnea or hypoventilation have arousal deficits to respiratory stimuli.

Key Words: myelomeningocele • hypoxia • hypercapneia • arousal response • apnea

Submitted on July 25, 1985




This article has been cited by other articles:


Home page
 J Child NeurolHome page
E. Tirosh and M. Jaffe
Apparent Life-Threatening Event: A Neurologic Perspective
J Child Neurol, May 1, 1995; 10(3): 216 - 218.
[Abstract] [PDF]

Home page
 J Child NeurolHome page
G. S. Liptak, J. W. Bloss, H. Briskin, J. E. Campbell, E. B. Hebert, and G. M. Revell
Review Article: The Management of Children With Spinal Dysraphism
J Child Neurol, January 1, 1988; 3(1): 3 - 20.
[Abstract] [PDF]