Sleep apnea and hypoxemia in recently weaned premature infants with and without bronchopulmonary dysplasia

Infants with bronchopulmonary dysplasia (BPD) experience significant hypoxemia. Apnea indices and oxygen saturation levels of ten infants with BPD were compared to ten healthy premature infants who were evaluated to rule out apnea or bradycardia prior to discharge from the hospital. Infants with BPD who had been recently (< 7 days) weaned from supplemental oxygen were evaluated on and off supplemental oxygen. Premature controls had never received oxygen nor ventilation assistance. Infants with BPD were born significantly more prematurely (28.1 ± 1.0 vs. 33.0 ± 3.9 weeks; P = 0.0012) while chronologic ages at the time of evaluation, adjusted for prematurity, were equal (37.1 ± 3.1 vs. 38.0 ± 2.7 weeks). Comparisons of apnea densities (expressed as percent of sleep time) between BPD and non‐BPD prematures revealed the following: neither the average obstructive apnea (0.15 ± 0.36 vs. 0.14 ± 0.31) nor periodic breathing densities (6.0 ± 8.56 vs. 10.2 ± 5.84) were different. Infants with BPD experienced significantly more central apnea (0.62 ± 0.34 vs. 0.16 ± 0.11; P = 0.003) than did non‐BPD prematures. Average oxygen saturation levels were significantly less among BPD vs. non‐BPD prematures (90.0 ± 10.18% vs. 95.7 ± 4.33%; P = 0.033). When supplemented with oxygen, BPD prematures had significantly higher saturation (X̄ = 94.5%) than when breathing room air (X̄ = 90.0%). Both central apnea and periodic breathing densities declined significantly with this improvement in saturation (0.64 vs. 0.04% and 6.0 vs. 1.4%, respectively). These data suggest that saturation status may indicate central respiratory stability in chronic lung disease. Pediatr Pulmonol 1991; 10:112–116.

[1]  J. H. Comroe,et al.  The effect of the inhalation of high and low oxygen concentrations on respiration, pulse rate, ballistocardiogram and arterial oxygen saturation (oximeter) of normal individuals. , 1947, The American journal of physiology.

[2]  S. Siegel,et al.  Nonparametric Statistics for the Behavioral Sciences , 2022, The SAGE Encyclopedia of Research Design.

[3]  W. Northway,et al.  Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. , 1967, The New England journal of medicine.

[4]  P. Winter,et al.  The toxicity of oxygen. , 1972, Anesthesiology.

[5]  R. Naeye Hypoxemia and the Sudden Infant Death Syndrome , 1974, Science.

[6]  J. Fleiss Statistical methods for rates and proportions , 1974 .

[7]  A. Stark,et al.  Bronchopulmonary dysplasia: possible relationship to pulmonary edema. , 1978, The Journal of pediatrics.

[8]  C. Guilleminault,et al.  Mixed and obstructive sleep apnea and near miss for sudden infant death syndrome: 2. Comparison of near miss and normal control infants by age. , 1979, Pediatrics.

[9]  Effect of oxygen administration during sleep on skin surface oxygen and carbon dioxide tensions in patients with chronic lung disease. , 1981, Pediatrics.

[10]  R. Neff,et al.  Sudden infant death syndrome in infants with bronchopulmonary dysplasia. , 1982, Pediatrics.

[11]  E. Bancalari,et al.  Early prediction of chronic lung disease by pulmonary function testing. , 1983, The Journal of pediatrics.

[12]  T. Boat,et al.  Concentrations of alpha 1-proteinase inhibitor and alpha 2-macroglobulin in serum and lung secretions of intubated infants. , 1984, Pediatric research.

[13]  M. Palmer Clinical Trials: A Practical Approach , 1985 .

[14]  T. Keens,et al.  Clinically unsuspected hypoxia during sleep and feeding in infants with bronchopulmonary dysplasia. , 1988, Pediatrics.