Abstract
In studies in the newborn infant, it is often assumed that there are similarities in airflow in successive breaths, and, therefore, it is only necessary to measure parameters in a small number of breaths. However, other studies have shown considerable variability in breathing patterns in successive breaths. It was, therefore, decided to examine the variability in the patterns of airflow. By use of the trunk plethysmograph, tidal breathing was measured in 20 term newborn infants during quiet sleep in the first week after delivery; airflow was calculated by differentiating the tidal volume signal. The ECG was also recorded. In all infants, it was found that the shapes of both inspiratory and expiratory airflow showed considerable differences in successive breaths. Spectral analysis of airflow showed the presence of peaks not only in the respiratory rate, as expected, but also in the heart rate. In another five infants studied during episodes of periodic breathing, small fluctuations in airflow were found during the apneic intervals at the same rate as the heart rate. It was concluded that this is not an artifact, but that cardiac contraction modulates respiratory airflow in the term newborn infant, contributing significantly to breath-to-breath variability. These cardiac related changes in airflow amount to approximately one sixth of the tidal airflow.
Department of Child Health, St. Bartholomew's & the Royal London School of Medicine and Dentistry, Queen Mary and Westfield College, University of London, London E1 2AD, United Kingdom
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References
Priban IP 1965 Self-adaptive control and the respiratory system. Nature 208: 339–343
Hlastala MP, Wranne B, Lenfant CJ 1973 Cyclical variations in FRC and other respiratory variables in resting man. J Appl Physiol 34: 670–676
Larsson H, Hellstrom LG, Linnarsson D 1993 Breath-by-breath determination of inspiratory occlusion pressure. Clin Physiol 13: 133–142
Luisada A 1942 The internal pneumocardiogram. Am Heart J 23: 676–691
Dahlstrom H, Murphy JP, Roos A 1954 Cardiogenic oscillations in composition of expired gas. J Appl Physiol 7: 335–339
Langer GA, Bornstein DL, Fishman AP 1960 Cardiogenic oscillations in expired nitrogen and regional alveolar hypoventilation. J Appl Physiol 15: 855–862
West JB, Hugh-Jones P 1961 Pulsatile gas flow in bronchi caused by the heart beat. J Appl Physiol 16: 697–702
Bachy JP, Eberhard A, Baconnier P, Benchetrit G 1986 A program for cycle-by-cycle shape analysis of biological rhythms. Comp Methods Prog Biomed 23: 297–307
Benchetrit G, Shea SA, Pham Dinh T, Bodocco S, Baconnier P, Guz A 1989 Individuality of breathing patterns in adults assessed over time. Respir Physiol 75: 199–210
Stick SM, Ellis E, LeSouëf PN, Sly PD 1992 Validation of respiratory inductance plethysmography (“Respitrace”) for the measurement of tidal breathing parameters in newborns. Pediatr Pulmonol 14: 187–191
Radvanyi-Bouvet MF, Monset-Couchard M, Morel-Kahn F, Vicente G, Drefus-Brisac C 1982 Expiratory patterns during sleep in normal full-term and premature neonates. Biol Neonate 41: 74–84
Stocks J, Dezateux CA, Jackson EA, Hoo AF, Costeloe KL, Wade AM 1994 Analysis of tidal breathing parameters in infancy: how variable is TPTEF:TE?. Am J Respir Crit Care Med 150: 1347–1354
Kosch PC, Hutchison AA, Wozniak JA, Carlo WA, Stark AR 1988 Posterior cricoarytenoid and diaphragm activities during tidal breathing in neonates. J Appl Physiol 64: 1968–1978
Prechtl H, Beintema D 1964 The Neurological Examination of the Fullterm Newborn Infant. Little Club Clinics in Developmental Medicine No 12. The Spastics Society Medical Education and Information Unit in Association with William Heinemann Medical Books Ltd, London, pp 6–8
Manning DJ, Bowden PJ, Stothers JK, Hathorn MKS, Cross KW 1987 The effect of sleep state on the early response of the neonate to hypoxia. Early Hum Dev 15: 183abstr
Manning DJ, Stothers JK 1991 Sleep state, hypoxia, and periodic breathing in the neonate. Acta Paediatr Scand 80: 763–769
Lewis SR 1969 Mechanics of respiration in the human infant with special reference to pulmonary compliance. PhD dissertation, University of London, England, pp 52–60, 82–98, 329–343
Cross KW 1949 The respiratory rate and ventilation in the newborn baby. J Physiol Lond 109: 459–474
Cross KW 1965 Respiration and oxygen supplies in the newborn. In: Fenn WO, Rahn H (eds) Handbook of Physiology Section 3: Respiration. American Physiological Society, Washington, DC, pp 1329–1343
Hathorn MKS 1987 Respiratory sinus arrhythmia in newborn infants. J Physiol Lond 385: 1–12
Hathorn MKS 1989 Respiratory modulation of heart rate in newborn infants. Early Hum Dev 20: 81–99
Okada M 1979 A digital filter for the QRS complex detection. IEEE Trans Biomed Eng 26: 700–703
Laxminarayan S, Spoelstra AJG, Sipkema P, Westerhof N 1978 Transpulmonary pressure and lung volume of cat and newborn–removal of cardiac effects with a digital filter. Med Biol Eng Comput 16: 397–407
Bendat JS, Piersol AG 1966 Measurement and Analysis of Random Data. John Wiley & Sons Inc, New York, pp 278–320
Dixon MJ ( ed) 1970 BMD Biomedical Computer Programs, 2nd Ed. University of California Press, Berkeley, CA, pp 459–482
Stata Corporation 1993 Stata Reference Manual: Release 3.1, 6th Ed. College Station, TX, pp 2: 141–171, 3:110–125
Itoh A, Ishida A, Kikuchi N, Okazaki N, Ishihara T, Kira S 1982 Non-invasive ventilatory volume monitor. Med Biol Eng Comput 20: 613–619
Fleming PJ, Levine MR, Goncalves A 1982 Changes in respiratory pattern resulting from the use of a face mask to record respiration in newborn infants. Pediatr Res 16: 1031–1034
Goldman SL, Brady JP, Dumpit FM 1979 Increased work of breathing associated with nasal prongs. Pediatrics 64: 160–164
Marsh MJ, Ingram D, Milner AD 1993 The effect of instrumental dead space on measurement of breathing pattern and pulmonary mechanics in the newborn. Pediatr Pulmonol 16: 316–322
Pichot V, Gaspoz JM, Molliex S, Antoniadis A, Busso T, Roche F, Costes F, Quintin L, Lacour JR, Barthelemy JC 1999 Wavelet transform to quantify heart rate variability and to assess its instantaneous changes. J Appl Physiol 86: 1081–1091
Reller M, Kotagal UR, Meyer RA, Kaplan S 1986 Duration of ventricular ejection during spontaneous breathing and positive pressure ventilation in newborn infants. Biol Neonate 50: 130–135
Toska K, Eriksen M 1993 Respiration-synchronous fluctuations in stroke volume, heart rate, and arterial pressure in humans. J Physiol Lond 472: 501–512
Acknowledgements
The author thanks the mothers for their cooperation with the study, Ruth Warner for assistance with the measurements on the babies, Trina Bunker and T.G. Barnett for their expert technical assistance, and Prof. Kate Costeloe for her encouragement.
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Supported in part by grant number 16935 from The Wellcome Trust.
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Hathorn, M. Cardiac Contraction Affects Respiratory Airflow in the Term Newborn Infant. Pediatr Res 48, 50–57 (2000). https://doi.org/10.1203/00006450-200007000-00011
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DOI: https://doi.org/10.1203/00006450-200007000-00011
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