Control of Breathing in Neonates and Infants

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Control of Breathing in Neonates and Infants

Response to Hypoxemia in Infants

Infants

During the first 2 to 3 weeks of age, both full-term and premature infants in a warm environment respond to hypoxemia (15% oxygen) with a transient increase in ventilation followed by sustained ventilatory depression (Brady and Ceruti, 1966; Rigatto and Brady, 1972a, 1972b; Rigatto et al., 1975a) (Fig. 3-12). In infants born at 32 to 37 weeks’ gestation, the initial period of transient hyperpnea is abolished in a cool environment, indicating the importance of maintaining a neutral thermal environment (Cross and Oppe, 1952; Ceruti, 1966; Perlstein et al., 1970.

Contents

Development of the Respiratory System

• Prenatal Development of the Lungs

Neonatal Respiratory Adaptation

• Postnatal Development of the Lungs and Thorax

• Prenatal Development of Breathing

• Perinatal Adaptation of Breathing

Control of Breathing

• Neural Control of Breathing

• Chemical Control of Breathing

• Control of Breathing in Neonates and Infants

• Maintenance of the Upper Airway and Airway Protective Reflexes

• Anesthetic Effects on Control of Breathing

• Summary

Lung Volumes

• Postnatal Development of the Lungs

• Functional Residual Capacity and Its Determinants

• Mechanics of Breathing

• Elastic Properties

• Dynamic Properties

• Summary

Ventilation

• Dead Space and Alveolar Ventilation

• Distribution of Ventilation

• Clinical Implications

• Summary

Gas Diffusion

Pulmonary Circulation

• Perinatal and Postnatal Adaptation

• Nitric Oxide and Postnatal Adaptation

• Distribution of Pulmonary Perfusion

• Ventilation/Perfusion Relationships

Oxygen Transport

• Oxygen Affinity of Hemoglobin and P50

• Surface Activity and Pulmonary Surfactant

Ciliary Activity

Measurements of Pulmonary Function in Infants and Children

• Standard Tests of Pulmonary Function

• Evaluation of Upper Airway Function

• Airway Reactivity

• Pulmonary Function Tests in Infants

• Indications for and Interpretation of Pulmonary Function Tests

Special Consideration for Pediatric Lung Disease

• Asthma

• Bronchopulmonary Dysplasia (BPD)

• Chronic Aspiration

• Tracheomalacia and Bronchomalacia

• Cystic Fibrosis (CF)

• Duchenne’s Muscular Dystrophy (DMD) and Other Congenital Disorders of Neuromuscular Weakness

Summary