| Title: |
Quantitative and Qualitative Changes in Peripheral Chemoreceptor Activity in Preterm Infants |
| Authors: |
Mammel, Daniel M.; Carroll, John L.; Warner, Barbara B.; Edwards, Bradley A.; Mann, Dwayne L.; Wallendorf, Michael J.; Hoffmann, Julie A.; Conklin, Cameron M.; Pyles, Harley; Kemp, James S. |
| Contributors: |
National Heart, Lung, and Blood Institute |
| Source: |
American Journal of Respiratory and Critical Care Medicine ; volume 207, issue 5, page 594-601 ; ISSN 1073-449X 1535-4970 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2023 |
| Description: |
Rationale Preterm infants are at risk for ventilatory control instability that may be due to aberrant peripheral chemoreceptor activity. Although term infants have increasing peripheral chemoreceptor contribution to overall ventilatory drive with increasing postnatal age, how peripheral chemoreceptor contribution changes in preterm infants with increasing postmenstrual age is not known. Objectives To evaluate peripheral chemoreceptor activity between 32 and 52 weeks postmenstrual age in preterm infants, using both quantitative and qualitative measures. Methods Fifty-five infants born between 24 weeks, 0 days gestation and 28 weeks, 6 days gestation underwent hyperoxic testing at one to four time points between 32 and 52 weeks postmenstrual age. Quantitative V˙E decreases were calculated, and qualitative responses were categorized as apnea, continued breathing with a clear reduction in V˙E, sigh breaths, and no response. Measurements and Main Results A total of 280 hyperoxic tests were analyzed (2.2 ± 0.3 tests per infant at each time point). Mean peripheral chemoreceptor contribution to ventilatory drive was 85.2 ± 20.0% at 32 weeks and 64.1 ± 22.0% at 52 weeks. Apneic responses were more frequent at earlier postmenstrual ages. Conclusions Among preterm infants, the peripheral chemoreceptor contribution to ventilatory drive was greater at earlier postmenstrual ages. Apnea was a frequent response to hyperoxic testing at earlier postmenstrual ages, suggesting high peripheral chemoreceptor activity. A clearer description of how peripheral chemoreceptor activity changes over time in preterm infants may help explain how ventilatory control instability contributes to apnea and sleep-disordered breathing later in childhood. Clinical trial registered with www.clinicaltrials.gov (NCT03464396). |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1164/rccm.202206-1033oc |
| Availability: |
https://doi.org/10.1164/rccm.202206-1033oc; https://academic.oup.com/ajrccm/article-pdf/207/5/594/66437511/ajrccm_207_5_594.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.29C9609F |
| Database: |
BASE |