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Improved understanding of respiratory control —implications for the treatment of apnoea

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Abstract

Recurrent apnoea of prematurity should probably be regarded as more or less a physiological phenomenon providing that it is not precipitated by for example septicaemia and cerebral haemorrhage since the fetus of the corresponding age is only breathing episodically. Neonatal apnoea is probably not caused by a deficient respiratory rhythmic regeneration, but rather by respiratory inhibitory mechanisms induced by hyperthermia, hypoxia and adenosine. A more physiological approach should be taken in the treatment of apnoea. Some warning against the extensive use of xanthine derivatives should be raised.

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References

  1. Aranda JV, Turmen T (1979) Methylxanthines in apnea of prematurity. Clin Perinatol 6:87–108

    Google Scholar 

  2. Curzi-Dascalova L, Lebrun F, Korn G (1983) Respiratory frequency according to sleep states and age in normal premature infants: a comparison with full term infants. Pediatr Res 17:152–156

    Google Scholar 

  3. Daily EJR, Klaus M, Meyer HBP (1969) Apnea in premature infants: monitoring incidence, heart rate, changes, and an effect of environmental temperature. Pediatrics 43:510–518

    Google Scholar 

  4. Dawes GS (1984) The control of fetal breathing and skeletal muscle movements. J Physiol (Lond) 346:1–18

    Google Scholar 

  5. Euler von C (1986) Brain stem mechanisms for generation and control of breathing pattern. In: Fishman AP, Cherniack NS, Widdicombe JG (eds) Handbook of physiology. Williams and Wilkins, Baltimore, pp 621–647

    Google Scholar 

  6. Fleming PJ, Gilbert R, Azaz Y, Berry PJ, Rudd PT, Stewart A, Hall E (1990) Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case control study. BMJ 301:85–89

    Google Scholar 

  7. Gerhardt T, Bancalari E (1984) Apnea of prematurity. I. Lung function and regulation of breathing. Pediatrics 74:58–62

    Google Scholar 

  8. Hanson MA, Kumar P, Williams BA (1989) The effect of chronic hypoxia upon the development of respiratory chemoreflexes in the newborn kitten. J Physiol (Lond) 411:563–574

    Google Scholar 

  9. Hathorn MKS (1974) The death and rate of breathing in newborn infants in different sleep states. J Physiol (Lond) 243:101–113

    Google Scholar 

  10. Henderson-Smart DJ (1981) The effect of gestational age on the incidence and duration of recurrent apnoea in newborn babies. Aust Paediatr J 17:273–276

    Google Scholar 

  11. Hertzberg T, Hellström S, Lagercrantz H, Pequignot JM (1990) Development of the arterial chemoreflex and turnover of carotid body catecholamines in the newborn rat. J Physiol (Lond) 425:211–225

    Google Scholar 

  12. Johnston BM, Gluckman PD (1989) Lateral pontine lesions affect central chemosensitivity in unanaestherized fetal lambs. J Appl Physiol 67:1113–1118

    Google Scholar 

  13. Karlberg P, Wennergren G (1986). Respiratory control during onset of breathing. Cardiovasc. Respiratory Physiol Fetus Neonate 133:131–144

    Google Scholar 

  14. Kashiwagi M, Onimaru H, Homma I (1993) Effects of NMDA on respiratory neurons in newborn rat medulla in vitro. Brain Res Bull 32:65–69

    Google Scholar 

  15. Katz-Salamon M, Lagercrantz H (1994a) Hypoxic ventilatory defence in very preterm infants: attenuation after long term oxygen treatment. Arch Dis Child 70:F90-F95

    Google Scholar 

  16. Katz-Salamon M, Lagercrantz H, Jonsson B (1995) Blunted peripheral chemoreceptor responses to hyperoxia in a group of infants with bronchopulmonary dysplasia. Pediatr Pulm (in press)

  17. Lagercrantz H (1992) What does the preterm infant breathe for? Controversies on apnea of prematurity. Acta Paediatr 81:733–736

    Google Scholar 

  18. Milerad J, Lagercrantz H, Löfgren O (1985) Alveolar hypoventilation treated with medroxyprogesterone. Arch Dis Child 60:150–155

    Google Scholar 

  19. Miller MJ, Martin RJ (1992) Pathophysiology of apnea of primaturity In: Polin RA, Fox WW (eds) Fetal and neonatal physiology. Saunders. Philadelphia, pp 872–885

    Google Scholar 

  20. Otsuka H, Lindahl SGE, Lagercrantz H, Yamamoto Y (1994) Effects of NMDA and non-NMDA receptor antagonists on inspiratory neurons in the vitro brainstem-spinal cord preparation of newborn rat. Neurosci Lett 171:94–96

    Google Scholar 

  21. Perlstein P, Edwards H, Sutherland J (1970) Apnea in premature infants and incubator-air temeprature changes. N Engl J Med 282:461

    Google Scholar 

  22. Ruggins NR (1991) Pathophysiology of apnoea in preterm infants. Arch Dis Child 66:70–73

    Google Scholar 

  23. Runold M, Lagercrantz H, Prabhakar NR, Fredholm BB (1989) Role of adenosine in hypoxic ventilatory depression. J Appl Physiol 67:541–546

    Google Scholar 

  24. Speck DF, Feldman JL (1982) The effects of microstimulating and microlesions in the ventral and dorsal respiratory gruops in medulla of cat. J Neurosci 2:417–425

    Google Scholar 

  25. Upton CJ, Milner AD, Stokes GM (1991) Apnoea, bradycardia, and oxygen saturation in preterm infants. Arch Dis Child 66:381–385

    Google Scholar 

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Lagercrantz, H. Improved understanding of respiratory control —implications for the treatment of apnoea. Eur J Pediatr 154, S10–S12 (1995). https://doi.org/10.1007/BF02155104

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