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POST-SIGH APNEA REPRESENTS THE MAJORITY OF POST-OPERATIVE CENTRAL APNEA IN TERM INFANTS.

Karen A. Brown, MD^* and Jason H.T. Bates, PhD

^* Department of Anaesthesia, McGill University Health Centre/Montreal Children's Hospital, 2300 Tupper Street, Montreal, QC, Canada, H3H 1P3
Department of Medicine and Molecular Physiology and Biophysics, University of Vermont, Vermont, Burlington, USA

INTRODUCTION

It is known that infants aged less than 60 weeks are at risk for postoperative apnea (POA)¹, although the physiology predisposing to this increased risk is not well understood. Our aim was to elucidate the relationships between apnea and the breathing pattern in post-operative infants in an attempt to gain a better understanding of how control-of-breathing issues might predispose such infants to POA. We focussed our attention particularly on sighs, which are important respiratory events and occur frequently in infants.²

METHODS

With institutional approval and informed parental consent we recorded ribcage (RC) and abdominal (AB) excursions using inductance plethysmography for up to 6 hours continuously in 12 term infants. Central apnea (CA) were identified off-line when both RC and AB signals were quiescent for >5s. Apneas were identified by an automated analysis algorithm for offline validation.

RESULTS

Most CA (62% ± 30%) occurred immediately following a sigh (PSA) (identified as a large protracted excursion in both RC and AB).

Our results thus suggest that, in infants at risk for POA, CA are strongly associated with sighs and may share common mechanisms associated with the control of breathing.

Footnotes

Supported by the Canadian Anesthesiologists' Society.

REFERENCES

1 Anesthesiology 82:809-822

2 Biol. Neonate 74:16-21.

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