Subject(s)
Lung/growth & development , Adult , Animals , Child , Child, Preschool , Fetus/physiology , Hernias, Diaphragmatic, Congenital , Humans , Infant , Infant, Newborn , Lung/embryology , Lung/pathology , Lung/physiopathology , Lung Diseases/congenital , Lung Diseases/pathology , Pulmonary Artery/anatomy & histology , Pulmonary Circulation , Pulmonary Veins/anatomy & histology , Respiratory Tract Diseases/pathology , Respiratory Tract Diseases/physiopathologySubject(s)
Lung/physiology , Respiratory Function Tests/standards , Blood Gas Analysis/standards , Child , Female , Forced Expiratory Volume , Humans , Infant, Newborn , Lung Volume Measurements/standards , Male , Maximal Expiratory Flow Rate , Physical Exertion , Reference Values , Spirometry/standards , Vital CapacityABSTRACT
Heart rate and heart rate variability were studied during sleep at monthly intervals in 18 normal infants and 12 infants with aborted sudden infant death syndrome during the first four months of life. At each age studied and in both REM and quiet sleep, the aborted SIDS infants had a 5 to 10% faster heart rate. Moreover, the aborted SIDS infants had a 10 to 45% smaller beat-to-beat and overall heart rate variability. Although the differences in overall variability persisted after normalization by the absolute heart rate, the differences in the beat-to-beat variability narrowed. These findings, when taken in conjunction with our previous observation that aborted SIDS infants have a smaller QT index than normal infants, suggest that infants with aborted SIDS have an increase in sympathetic activity or in circulating levels of catecholamines.
Subject(s)
Heart Rate , Sleep/physiology , Sudden Infant Death/physiopathology , Female , Humans , Infant , Infant, Newborn , Male , Sleep, REM/physiologySubject(s)
Respiration , Respiratory System/innervation , Sensory Receptor Cells/physiology , Animals , Apnea/physiopathology , Carbon Dioxide/blood , Chemoreceptor Cells/physiology , Gestational Age , Humans , Infant , Infant, Newborn , Laryngeal Nerves , Lung Volume Measurements , Mechanoreceptors/physiology , Pulmonary Stretch Receptors/physiology , Reflex , Respiratory Center/physiology , Sudden Infant Death/physiopathology , Trigeminal Nerve/physiology , Vagus Nerve/physiologyABSTRACT
The signs of obstructive lung disease dominated the clinical course of ten infants with ventricular septal defects and large left-to-right shunts. Airway obstruction in these patients can be attributed (1) to increase in large airway resistance as the result of compression by enlarged pulmonary arteries or cardiac chambers and (2) to increase in small airway resistance as the result of accumulation of peribronchiolar fluid. The rapid regression of the signs of obstructive airway disease following open heart repair of the ventricular septal defect indicates that the lung disease observed in these infants is secondary to the ventricular septal defect, rather than a primary process. The most effective management in the refractory patients is that of open repair of the defect.