Respiratory Control and Disorders in the Newborn

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ISBN: 9780824709846 | 0824709845
Cover: Hardcover
Copyright: 1/28/2003

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This text analyses the pathophysiology, diagnosis, treatment and control of respiratory disorders in the newborn infant. It explores the mechanisms, patterns, and factors influencing respiratory activity and dysfunction, as well as the aetiology, management, and evaluation of conditions such as respiratory distress syndrome, bronchopulmonary dysplasia, airway disorders, and congenital hypoventilation syndromes.

Introduction

Claude Lenfant

Preface

vii

Contributors

Respiratory Control in the Newborn: Comparative Physiology and Clinical Disorders

(16)

Gabriel G. Haddad

Introduction

(1)

Overall Concepts of Respiratory Control

(4)

The Newborn's Respiratory Control in Perspective

(5)

Disease States

(2)

Summary

(4)

References

(4)

Gasping and Autoresuscitation

(22)

Walter M. St.-John

Introduction

(1)

Elicitation of Gasping

(1)

Characteristics of Gasping

(5)

Effectiveness of Gasping in Autoresuscitation

(1)

Failure of Gasping in Autoresuscitation

(1)

Critical Region for Neurogenesis of Gasping

(2)

Mechanisms for the Neurogenesis of Gasping

(5)

Summary

(7)

References

(6)

Ontogeny of Upper- and Lower-Airway Innervation

(44)

John T. Fisher

Cyril E. Schweitzer

Markus Weichselbaum

Malcolm P. Sparrow

Introduction

(1)

Anatomy, Morphology, and Distribution

(21)

Neurophysiologic Behavior of Airway Afferents

(22)

References

(10)

Chemical Control of Breathing from Fetal Through Newborn Life

(32)

Martha Jane Miller

Musa A. Haxhiu

Richard J. Martin

Introduction

(1)

Development of Chemoreception

(2)

Maturation of Chemoreceptor Responses to CO2/H+

(9)

Chemoreceptors for Oxygen and Their Role in Breathing

(21)

References

103

(12)

Upper-Airway Muscle Control During Development: Application to Clinical Disorders That Occur in Premature Infants

115

(34)

Estelle B. Gauda

Introduction

115

(2)

Apnea in Premature Infants: Incidence and Characterization

117

(1)

Pharynx: A Site of Upper-Airway Obstruction and the Role of Pharyngeal Dilator Muscles in Apnea

118

(1)

Brainstem Neuronal Network Responsible for Respiratory Rhythmogenesis

119

(2)

Hypoglossal Motoneurons During Postnatal Development

121

(3)

Upper-Airway Muscle Atonia During Sleep: Role of TRH, NE, and 5HT

124

(1)

Infants with BPD Have Increased Frequency of Apnea: Possible Mechanisms

125

(5)

The Larynx: A Site of Upper-Airway Obstruction During Apnea in Premature Infants

130

(1)

Role of Laryngeal Receptors in Modulation of Upper-Airway Muscle Responses

130

(4)

Why Therapies Are Effective in Treating Apnea in Premature Infants

134

(2)

Conclusions

136

(13)

References

137

(12)

Developmental Trend of Sleep Characteristics in Premature and Full-Term Newborns

149

(34)

Lilia Curzi-Dascalova

Introduction

149

(1)

Development of Behavioral States in Animals

150

(2)

Behavioral States in Early Human Ontogenesis

152

(12)

Neurophysiological Correlates of Sleep States in Premature and Full-Term Newborns

164

(6)

Comments and Summary

170

(13)

References

173

(10)

Metabolic and Ventilatory Interaction in the Newborn

183

(26)

Jacopo P. Mortola

Introduction

183

(1)

Glossary of Terms and Definitions

184

(1)

Interspecies Differences in Metabolic Rate

185

(1)

Metabolic Rate During Body Growth and Aging

186

(1)

Circadian Patterns of Metabolism

187

(2)

Changes in Temperature

189

(3)

Changes in Respiratory Gases

192

(7)

Extrapulmonary Gas Exchange

199

(2)

Summary and Concluding Remarks

201

(8)

References

203

(6)

Respiratory Control Disorders: An Overview

209

(8)

Oommen P. Mathew

Introduction

209

(1)

Respiratory Control Disorders

209

(3)

Assessment of Respiratory Control Disorders

212

(2)

Summary

214

(3)

References

215

(2)

Monitoring in the NICU

217

(20)

Christian F. Poets

Introduction

217

(1)

Electrocardiography (ECG) and Heart Rate Monitoring

217

(1)

Monitoring of Chest Wall Movements

218

(1)

Transcutaneous Partial Pressure of Oxygen (PTcCO2) Monitoring

219

(2)

Pulse Oximetry (SPO2)

221

(4)

Transcutaneous Partial Pressure of Carbon Dioxide (PTcCO2) Monitoring

225

(1)

End-Tidal Carbon Dioxide (ETCO2) Monitoring (Capnometry)

226

(3)

False Alarms in the NICU

229

(1)

Alarm Settings

230

(7)

References

231

(6)

Periodic Breathing

237

(36)

Henrique Rigatto

Introduction

237

(1)

Concept, Morphology, and Prevalence

237

(3)

History

240

(1)

Mechanisms of Periodic Breathing

241

(13)

The Clinical Scenario

254

(4)

Clinical Significance in Neonates

258

(3)

Long-Term Developmental Speculation

261

(12)

References

262

(11)

Apnea, Bradycardia, and Desaturation: Clinical Issues

273

(22)

Oommen P. Mathew

Introduction

273

(1)

Definition and Classification

273

(4)

Differential Diagnosis

277

(4)

Time of Occurrence

281

(1)

Significance of Sequence of Events

282

(2)

Episodic Bradycardia and Desaturation Among Intubated Infants

284

(2)

Apnea and Neurodevelopmental Outcome

286

(1)

Summary

287

(8)

References

288

(7)

Pathophysiology of Apnea of Prematurity: Implications from Observational Studies

295

(22)

Christian F. Poets

Introduction

295

(1)

Relationship Between Apnea, Bradycardia, and Desaturation

295

(3)

Changes in Lung Volume During Apnea

298

(1)

Role of Feeding and Gastroesophageal Reflux

299

(3)

Chest Wall Distortion, Anatomical Dead Space, and Diaphragmatic Fatigue

302

(2)

Upper-Airway Obstruction

304

(2)

Hypoxic Ventilatory Depression

306

(2)

Anemia

308

(1)

Termination of Apnea

309

(1)

Conclusion

310

(7)

References

310

(7)

Pharmacotherapy of Apnea of Prematurity

317

(18)

Alison Graham

Neil N. Finer

Introduction

317

(1)

Theophylline

317

(3)

Caffeine

320

(3)

Doxapram

323

(2)

Gastroesophageal Reflux and Apnea

325

(1)

Conclusion

326

(9)

References

327

(8)

Nonpharmacological Management of Idiopathic Apnea of the Premature Infant

335

(20)

Edward E. Lawson

Introduction

335

(1)

Positioning

336

(2)

Nonpharmacological Mechanisms to Stimulate the Central Nervous System

338

(4)

Thermal Environment

342

(1)

Oxygen

343

(3)

Mechanical Airway Support

346

(3)

Concluding Remarks

349

(6)

References

349

(6)

Maturation of Respiratory Control

355

(18)

Eric C. Eichenwald

Ann R. Stark

Introduction

355

(1)

Sleep and Breathing

356

(4)

Maturation of Neuromuscular Reflex Responses

360

(5)

Maturation of Respiratory Control: Resolution of Apnea of Prematurity

365

(3)

Conclusions

368

(5)

References

368

(5)

Respiratory Control During Oral Feeding

373

(22)

Oommen P. Mathew

Introduction

373

(1)

Sucking

374

(2)

Swallowing

376

(2)

Breathing

378

(6)

Disorders of Breathing During Feeding

384

(3)

Maturation

387

(1)

Summary

388

(7)

References

388

(7)

Idiopathic Congenital Central Hypoventilation Syndrome

395

(14)

Debra E. Weese-Mayer

Jean M. Silvestri

Introduction

395

(1)

Differential Diagnosis

395

(1)

Initial Evaluation

396

(1)

Control of Breathing Deficit

396

(1)

Associated Conditions

397

(1)

Autonomic Nervous System Dysfunction in CCHS

397

(1)

Familial Occurrence of CCHS

398

(1)

Familial Occurrence of ANSD

399

(1)

Ventilatory Support Options

400

(2)

Long-Term Comprehensive Management

402

(1)

Long-Term Outcome

402

(1)

Key to the Successful Management of the Child with CCHS

403

(1)

Limitations to Optimal Care for the Child with CCHS

404

(5)

References

404

(5)

Regulation of Breathing in Neuromuscular Diseases

409

(18)

Oommen P. Mathew

Introduction

409

(2)

Central Nervous System

411

(2)

Anterior Horn Cells

413

(2)

Nerves, Neuromuscular Junction, and Muscles

415

(4)

Summary

419

(8)

References

420

(7)

Regulation of Breathing in Acute Ventilatory Failure

427

(24)

Anne Greenough

Introduction

427

(1)

Respiratory Activity During Mechanical Ventilation

427

(4)

Respiratory Reflexes

431

(2)

Factors Influencing Respiratory Activity

433

(9)

Methods of Detecting Respiratory Activity During Mechanical Ventilation

442

(2)

Influence of Respiratory Activity on the Outcome of Mechanical Ventilation for Acute Ventilatory Failure

444

(7)

References

444

(7)

Respiratory Control in Bronchopulmonary Dysplasia

451

(22)

Miriam Katz-Salamon

Introduction

451

(1)

Definition and Etiology

452

(1)

Control of Breathing in BPD

453

(4)

Relationships Between Control of Heart Rate and Respiration

457

(2)

Hypoxemia in BPD

459

(2)

Respiration During Sleep in BPD

461

(2)

Respiratory Sequelae in BPD Infants

463

(1)

Short- and Long-Term Neuromotor and Cognitive Development

464

(1)

Conclusions

465

(8)

References

465

(8)

Gastroesophageal Reflux and Related Diseases

473

(22)

Taher Omari

Introduction

473

(1)

Gastrointestinal Motility

474

(3)

Gastroesophageal Reflux

477

(6)

Pathophysiology of GER Disease

483

(3)

Respiratory Disease and GER

486

(9)

References

490

(5)

Airway Disorders in the Newborn

495

(30)

Oommen P. Mathew

Introduction

495

(1)

Maintenance of Airway Patency

495

(4)

Airway Imaging Studies

499

(2)

Disorders of Airway Patency

501

(16)

Summary

517

(8)

References

517

(8)

SIDS and the Newborn Infant

525

(16)

Jean M. Silvestri

Debra E. Weese-Mayer

Introduction

525

(1)

Definition and Risk Factors

525

(1)

Age at Presentation

526

(1)

Gestational Age

526

(1)

Modifiable Risk Factors for SIDS

527

(7)

Summary

534

(7)

References

535

(6)

Author Index

541

(58)

Subject Index

599

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Respiratory Control and Disorders in the Newborn

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