Effect on ventilation of change to the upright posture in newborn infants. 1984

A R Stark, and T B Waggener, and I D Frantz, and B A Cohlan, and H A Feldman, and P C Kosch

We have investigated the effect of postural change on tidal volume (VT), inspiratory (TI) and expiratory (TE) duration, minute ventilation (VI), and end-tidal PCO2 in a group of 11 healthy full-term sleeping infants, 2-4 days of age. During tilts from the supine to upright posture, the average volume increase was 4.3 +/- 4.4 (SD) ml or 1.2 ml/kg in the maneuvers unassociated with sighs. In the 20% of tilts in which sighs occurred, the average volume change was slightly higher. Transition from supine to upright posture resulted in statistically significant increases in VT (6.45 +/- 0.06 to 6.72 +/- 0.06 ml/kg), TI (554 +/- 7 to 604 +/- 7 ms), and TE (629 +/- 12 to 777 +/- 14 ms), and decrease in VI (328 +/- 5 to 288 +/- 4 ml X kg-1 X min-1) (all means +/- SE, P less than 0.0005). Return to supine position resulted in statistically significant changes in the opposite direction. Tilting to the upright posture brought about a small (0.4 +/- 0.1 Torr, means +/- SE) but consistent statistically significant increase in end-tidal PCO2, which persisted through the first minute when the infant was returned to the supine position. The expiratory prolongation observed with tilting appears to minimize changes in end-expiratory lung volume, obviating the need for an effective compensatory muscle response to defend ventilation. Thus it appears that infants, in contrast to adults, adopt a breathing strategy to limit the extent of change in absolute lung volume, rather than to defend ventilation at increased lung volume.

UI MeSH Term Description Entries
D007231 Infant, Newborn An infant during the first 28 days after birth. Neonate,Newborns,Infants, Newborn,Neonates,Newborn,Newborn Infant,Newborn Infants
D010313 Partial Pressure The pressure that would be exerted by one component of a mixture of gases if it were present alone in a container. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Partial Pressures,Pressure, Partial,Pressures, Partial
D011187 Posture The position or physical attitude of the body. Postures
D012119 Respiration The act of breathing with the LUNGS, consisting of INHALATION, or the taking into the lungs of the ambient air, and of EXHALATION, or the expelling of the modified air which contains more CARBON DIOXIDE than the air taken in (Blakiston's Gould Medical Dictionary, 4th ed.). This does not include tissue respiration ( Breathing
D002245 Carbon Dioxide A colorless, odorless gas that can be formed by the body and is necessary for the respiration cycle of plants and animals. Carbonic Anhydride,Anhydride, Carbonic,Dioxide, Carbon
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013990 Tidal Volume The volume of air inspired or expired during each normal, quiet respiratory cycle. Common abbreviations are TV or V with subscript T. Tidal Volumes,Volume, Tidal,Volumes, Tidal
D013997 Time Factors Elements of limited time intervals, contributing to particular results or situations. Time Series,Factor, Time,Time Factor

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