PEDIATRICS Vol. 89 No. 5 May 1992, pp. 860-864
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 Ward, S. L. D.
Right arrow Articles by Keens, T. C.
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. C.

Hypoxic Arousal Responses in Normal Infants

Sally L. Davidson Ward MD1, Daisy B. Bautista CPFT1, and Thomas C. Keens MD1

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

Failure to arouse in response to hypoxia has been described in infants at increased risk for sudden infant death syndrome (SIDS) and has been suggested as a possible mechanism for SIDS. However, most SIDS victims are not in a high-risk group before death. Thus, if a hypoxic arousal disorder is an important contributor to SIDS, normal infants might fail to arouse from sleep in response to hypoxia. To test this hypothesis, the authors studied hypoxic arousal responses in 18 healthy term infants younger than 7 months of age (age 12.1 ± 1.7 [SEM] weeks; 56% girls). Hypoxic arousal challenges were performed during quiet sleep by rapidly decreasing inspired oxygen tension (Pio2) to 80 mm Hg for 3 minutes or until arousal (eye opening, agitation, and crying) occurred. Tests were performed in duplicate when possible. Only 8 infants (44%) aroused in response to one or more hypoxic challenges; arousal occurred during 8 (32%) of 25 trials. There were no significant differences in lowest Pio2 or arterial oxygen saturation during hypoxia between those infants who aroused and those who failed to arouse. All 18 infants had a fall in their end-tidal carbon dioxide tension during hypoxia, suggesting that each had a hypoxic ventilatory response despite failure to arouse in the majority. Periodic breathing occurred following hypoxia in only 1 (13%) of the 8 trials that resulted in arousal, compared with 16 (94%) of 17 trials without arousal (P < .005). It is concluded that the majority of normal infants younger than 7 months of age fail to arouse from quiet sleep in response to hypoxia, despite the apparent presence of a hypoxic ventilatory response.

Key Words: sudden infant death syndrome • hypoxia • arousal responses

Submitted on April 11, 1991
Accepted on June 24, 1991




This article has been cited by other articles:


Home page
 Am. J. Respir. Crit. Care Med.Home page
K. A. Waters and K. D. Tinworth
Habituation of Arousal Responses after Intermittent Hypercapnic Hypoxia in Piglets
Am. J. Respir. Crit. Care Med., June 1, 2005; 171(11): 1305 - 1311.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
I. Kato, P. Franco, J. Groswasser, S. Scaillet, I. Kelmanson, H. Togari, and A. Kahn
Incomplete Arousal Processes in Infants Who Were Victims of Sudden Death
Am. J. Respir. Crit. Care Med., December 1, 2003; 168(11): 1298 - 1303.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
A. L. Patel, D. Paluszynska, K. A. Harris, and B. T. Thach
Occurrence and Mechanisms of Sudden Oxygen Desaturation in Infants Who Sleep Face Down
Pediatrics, April 1, 2003; 111(4): e328 - 332.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
F. R. Hauck, C. M. Moore, S. M. Herman, M. Donovan, M. Kalelkar, K. K. Christoffel, H. J. Hoffman, and D. Rowley
The Contribution of Prone Sleeping Position to the Racial Disparity in Sudden Infant Death Syndrome: The Chicago Infant Mortality Study
Pediatrics, October 1, 2002; 110(4): 772 - 780.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
A. L. Patel, K. Harris, and B. T. Thach
Inspired CO2 and O2 in sleeping infants rebreathing from bedding: relevance for sudden infant death syndrome
J Appl Physiol, December 1, 2001; 91(6): 2537 - 2545.
[Abstract] [Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
B C Galland, D P G Bolton, B J Taylor, R M Sayers, and S M Williams
Ventilatory sensitivity to mild asphyxia: prone versus supine sleep position
Arch. Dis. Child., November 1, 2000; 83(5): 423 - 428.
[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
 PediatricsHome page
S. Mosko, C. Richard, and J. McKenna
Infant Arousals During Mother-Infant Bed Sharing: Implications for Infant Sleep and Sudden Infant Death Syndrome Research
Pediatrics, November 1, 1997; 100(5): 841 - 849.
[Abstract] [Full Text] [PDF]

Home page
 PediatricsHome page
B. T. Skadberg and T. Markestad
Consequences of Getting the Head Covered During Sleep in Infancy
Pediatrics, August 1, 1997; 100(2): e6 - e6.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
F. McNamara, F. G. Issa, and C. E. Sullivan
Arousal pattern following central and obstructive breathing abnormalities in infants and children
J Appl Physiol, December 1, 1996; 81(6): 2651 - 2657.
[Abstract] [Full Text] [PDF]