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furthermore, it is likely that recurrent hypoxia is the detrimental feature of the potential longer term abnormalities exhibited by preterm infants. the incidence of intermittent hypoxic episodes in preterm infants is relatively low during the first week of life and then increases rapidly and is sustained over several weeks.41 this time course may correspond to a postnatal rise in peripheral chemosensitivity and resultant respiratory instability as discussed earlier. figure 3 4 summarizes proposed morbidities that might be attributable to intermittent hypoxic episodes in early life.42 these proposed clinical consequences of neonatal intermittent hypoxia need to be correlated with physiology studies that document any modulatory effects upon neuronal plasticity related to peripheral and/or central respiratory control mechanisms. we are currently learning a lot from ongoing studies in cohorts of former preterm infants. for example, the incidence of sleep disordered breathing is exceedingly high in children born prematurely regardless of whether they were randomized to caffeine vs placebo therapy.43 elevated blood pressure is seen in prematurely born adolescents.44 is this the result of intermittent hypoxia induced inflammatory changes in the vasculature45? much work remains to be done to elicit the biological basis for the sequelae we observe in preterm infants and the roles of both respiratory control and ventilatory management in their pathogenesis.

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Son Güncelleme: 2019-02-04
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Referans: Anonim

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