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Hypercarbic ventilatory responses of infants at risk for SIDS
Author(s) -
Coleman J. Michael,
Mammel Mark C.,
Reardon Christine,
Boros Stephen J.
Publication year - 1987
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.1950030406
Subject(s) - sudden infant death syndrome , medicine , apnea , periodic breathing , tidal volume , ventilation (architecture) , hypoxic ventilatory response , anesthesia , apnea of prematurity , control of respiration , pediatrics , respiratory system , gestational age , pregnancy , mechanical engineering , biology , engineering , genetics
We examined the hypercarbic ventilatory responses (HVR) of 143 infants at risk for sudden infant death syndrome (SIDS) and 34 normal control infants. Sixty‐five of the atrisk infants had experienced apparent life‐threatening events (ALTE), and 78 were siblings of SIDS victims. Twenty‐three (35%) of the ALTE infants experienced subsequent apnea; one died of SIDS. Seven (9%) of the SIDS siblings experienced subsequent apnea; two ultimately died of SIDS. In the HVR studies, we measured tidal volume (V T ), minute ventilation (V E ), frequency of breathing (f), and end‐tidal P CO 2 (P ETCO 2 ) at rest and while breathing 2% and 4% CO 2 . Mean HVR values for the ALTE, sibling, and control groups were all similar. The mean HVR values for those at‐risk infants who experienced subsequent apnea were not different from those who did not experience subsequent apnea. However, those infants experiencing subsequent apnea had higher mean V T /kg values (P < 0.01) and lower mean P ETCO 2 values (P < 0.001) than those who did not. The SIDS siblings had significantly lower resting V T /kg values than either the near‐miss infants or normal controls (P < 0.01). We did not find depressed HVR values in infants at risk for SIDS. On the contrary, those infants who experienced subsequent apnea had evidence suggesting relative hyper ventilation. SIDS siblings had evidence suggesting relative hypo ventilation. These findings are interesting and thought‐provoking. However, HVR studies do not appear to be sensitive, specific, or appropriate for the general screening of infants at risk for SIDS.