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Respiratory inhibition after crying in infants
Author(s) -
MINOWA HIDEKI,
KUBO SATOMI,
YOSHIZAWA HIROYUKI,
HAYASHI YUKIKO,
HAYASHI TAMAKI,
YOSHIDA KOICHI,
EBISU REIKO,
UCHIDA YUMIKO,
OHGITANI AYAKO
Publication year - 2006
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.2006.02269.x
Subject(s) - medicine , crying , respiratory system , echogenicity , apnea , anesthesia , pediatrics , ultrasonography , surgery , psychiatry
Background: Among full‐term neonates, the authors discovered infants who showed respiratory inhibition after crying which involved a marked decrease in SpO 2 . The infants were found to present increased echogenicity or a cyst in a cranial region termed the ganglionic eminence, or to have a subependymal cyst. The authors prospectively examined the relationship between respiratory inhibition after crying and these changes to examine the prevention and treatment of the episode. Methods: The authors conducted cranial ultrasonography to screen 381 full‐term neonates who showed no abnormalities at birth and whose parents requested ultrasonographic screening of the head, followed by polygraphy of infants who showed increased echogenicity or a cyst in ganglionic eminence, or had a subependymal cyst. The authors similarly conducted polygraphy for 50 neonates without cranial ultrasound abnormalities; the former constituted the control group. Respiratory inhibition was defined to be central apnea immediately after crying with a decrease in SpO 2 to <60%. Results: Among 381 neonates examined, 104 showed cranial ultrasound abnormalities; 60 of the 104 neonates indicated respiratory inhibition after crying. Oxygenation failed to improve the episode in 17 neonates with severe respiratory inhibition. However, theophylline alleviated the episode, and SpO 2 no longer decreased to <60%. Theophylline was discontinued successfully by 6 months after birth, while 50 neonates in the control group showed no respiratory inhibition after crying. Conclusion: Respiratory inhibition after crying which involved a marked decrease in SpO 2 was observed in full‐term neonates who showed no abnormalities after birth. These neonates could be screened by cranial ultrasonography.