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The hypoxic test in preterm neonates reinvestigated
Author(s) -
Kouakam Christelle,
StephanBlanchard Erwan,
Léké André,
Kongolo Guy,
Haraux Elodie,
Delanaud Stéphane,
Telliez Frédéric,
Chardon Karen
Publication year - 2018
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.23907
Subject(s) - medicine , peripheral chemoreceptors , anesthesia , hypoxia (environmental) , chemoreceptor , bronchopulmonary dysplasia , central chemoreceptors , ventilation (architecture) , rapid eye movement sleep , peripheral , respiratory minute volume , respiratory system , control of respiration , eye movement , gestational age , oxygen , pregnancy , mechanical engineering , chemistry , receptor , organic chemistry , biology , engineering , genetics , ophthalmology
Aim We currently lack a suitable gold‐standard method for implementation on modern equipment to assess peripheral chemoreceptor sensitivity. The aim of the present study was to develop an accurate and reproducible method for assessing peripheral chemoreceptors sensitivity in sleeping preterm neonates. Methods A poïkilocapnic hypoxic test was performed twice during rapid eye movement sleep (REM sleep) and non‐rapid eye movement sleep (nonREM sleep). The infant breathed hypoxic gas (15% O 2 ) for 60 s. The ventilatory response to hypoxia was assessed by comparing minute ventilation during the control period (21% O 2 ) with successive 4‐cycles sequences during hypoxia. We detected the first statistically significant increase in minute ventilation and recorded the corresponding response time. Results During normoxia, minute ventilation was higher during REM sleep than in nonREM sleep (428.1 mL · min −1 · kg −1 [307.7‐633.6]; 388.8 mL · min −1 · kg −1 [264.7‐608.0], respectively; P = 0.001). After hypoxia, minute ventilation increased in both REM and nonREM sleep. The response was significantly higher in REM than in nonREM (25.3% [10.8‐80.0] and 16.8% [7.5‐33.2], respectively; P = 0.005). The intraclass correlation coefficients for all respiratory parameters were above 0.90. Conclusion We have developed a highly reliable method for assessing peripheral chemoreceptors sensitivity at the response time to hypoxia. In the future, researchers could use this method to assess the involvement of peripheral chemoreceptors in infants who experience chronic hypoxia (e.g. in bronchopulmonary dysplasia and recurrent apnea).