PEDIATRICS Vol. 79 No. 2 February 1987, pp. 269-274
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Elevated Catecholamine Levels and Abnormal Hypoxic Arousal in Apnea of Infancy

Antonio M. Rodriguez MD1, David Warburton BSc, MB, MRCP1, and Thomas G. Keens MD1

1 From the Division of Neonatology and Pediatric Pulmonology, Childrens Hospital of Los Angeles, University of Southern California School of Medicine, Los Angeles

Arousal from quiet sleep in response to a hypoxic challenge fails to occur in many patients with apnea of infancy. It was hypothesized that catecholamine-mediated responses might be involved in the depressed hypoxic arousal response in apnea of infancy and that these differences would be reflected in serum catecholamine concentrations. Fifteen infants with a median age of 5.5 months and a history of unexplained apnea during sleep were studied. Two hypoxic challenges (PiO2, 80 mm Hg) were given for three minutes or until arousal from quiet sleep occurred. Of the 15 patients with apnea of infancy 11 (73%) did not arouse to hypoxia. These infants had serum epinephrine levels that were elevated 4.1-fold while awake (P < .05), 3.4-fold during quiet sleep (P < .02), and 3.5-fold during hypoxia (P < .05). They also had serum norepinephrine levels that were elevated threefold while awake (P < .05), 5.3-fold during quiet sleep (P < .001), 3.2-fold during hypoxia (P < .02), and 12-fold during recovery from hypoxia (P < .001) in comparison with the corresponding levels in the four (23%) infants who aroused normally to hypoxia. It is speculated that elevated circulating catecholarnines are associated with abnormal hypoxic arousal responses in children with apnea of infancy.

Key Words: catecholamine • hypoxia • arousal • infant apnea

Submitted on November 11, 1985
Accepted on April 21, 1986




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A. Steinschneider, C. Richmond, V. Ramaswamy, and A. Curns
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[Abstract] [PDF]