DOI QR코드

DOI QR Code

Augmentation of respiratory muscle activities in preterm infants with feeding desaturation

  • Kwon, Dong Rak (Department of Rehabilitation Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine) ;
  • Park, Gi Young (Department of Rehabilitation Medicine, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine) ;
  • Jeong, Ji Eun (Department of Pediatrics, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine) ;
  • Kim, Woo Taek (Department of Pediatrics, Daegu Catholic University Medical Center, Catholic University of Daegu School of Medicine) ;
  • Lee, Eun Joo (Department of Pediatrics, Kyungpook National University Medical Center, Kyungpook National University School of Medicine)
  • Received : 2017.06.08
  • Accepted : 2017.10.12
  • Published : 2018.03.15

Abstract

Purpose: Frequent desaturation due to immature incoordination of suck-swallow-breathing in preterm infants can influence multiple organs such as the heart, lungs, and brain, which can then affect growth and development. Most notably in preterm infants, feeding desaturation may even affect pulmonary function during gavage feeding. Because respiratory muscle activities may reflect the work required during respiration, we evaluated the differences in these activities between full-term and preterm infants with feeding desaturation, and investigated the correlations with clinical variables. Methods: Nineteen preterm infants with feeding desaturation (group 1) and 19 age-matched full-term infants (group 2) were evaluated. Oromotor function was evaluated using video recording. The root-mean-square (RMS) envelope of the electromyography signal was calculated to quantify the activities of muscles involved in respiration. The differences in RMS between both groups and the correlation with clinical variables including gestational age (GA), birth weight (BW), and Apgar scores (AS) at 1 and 5 minutes after birth were evaluated. Results: The RMS values of the diaphragm (RMS-D) and rectus abdominis (RMS-R) were significantly greater in group 1 compared to group 2, and the 1- and 5-min AS were significantly lower in group 1 compared to group 2. RMS-D and RMS-R were inversely correlated with GA, BW, 1- and 5-min AS in all infants. Conclusion: This study showed that respiratory muscle activities were augmented during feeding in preterm infants compared to full-term infants. Additionally, respiratory muscle activities were inversely correlated with all clinical variables.

Keywords

References

  1. Bosma JF. Development of feeding. Clini Nutr 1986;5:210-8.
  2. Lau C, Smith EO, Schanler RJ. Coordination of suck-swallow and swallow respiration in preterm infants. Acta Paediatr 2003;92:721-7. https://doi.org/10.1111/j.1651-2227.2003.tb00607.x
  3. Shivpuri CR, Martin RJ, Carlo WA, Fanaroff AA. Decreased ventilation in preterm infants during oral feeding. J Pediatr 1983;103:285-9. https://doi.org/10.1016/S0022-3476(83)80368-0
  4. Heldt GP. Development of stability of the respiratory system in preterm infants. J Appl Physiol (1985) 1988;65:441-4. https://doi.org/10.1152/jappl.1988.65.1.441
  5. Mathew OP. Respiratory control during nipple feeding in preterm infants. Pediatr Pulmonol 1988;5:220-4. https://doi.org/10.1002/ppul.1950050408
  6. Rosen CL, Glaze DG, Frost JD Jr. Hypoxemia associated with feeding in the preterm infant and full-term neonate. Am J Dis Child 1984;138:623-8.
  7. Nugent ST, Finley JP. Spectral analysis of the EMG and diaphragmatic muscle fatigue during periodic breathing in infants. J Appl Physiol (1985) 1985;58:830-3. https://doi.org/10.1152/jappl.1985.58.3.830
  8. Choi HW, Park HW, Kim HY, Lim G, Koo SE, Lee BS, et al. Feeding Desaturation and Effects of Orocutaneous Stimulation in Extremely Low Birth Weight Infants. J Korean Soc Neonatol 2010;17:193-200. https://doi.org/10.5385/jksn.2010.17.2.193
  9. Poets CF, Langner MU, Bohnhorst B. Effects of bottle feeding and two different methods of gavage feeding on oxygenation and breathing patterns in preterm infants. Acta Paediatr 1997;86:419-23. https://doi.org/10.1111/j.1651-2227.1997.tb09034.x
  10. Thoyre SM, Carlson J. Occurrence of oxygen desaturation events during preterm infant bottle feeding near discharge. Early Hum Dev 2003;72:25-36. https://doi.org/10.1016/S0378-3782(03)00008-2
  11. Blondheim O, Abbasi S, Fox WW, Bhutani VK. Effect of enteral gavage feeding rate on pulmonary functions of very low birth weight infants. J Pediatr 1993;122(5 Pt 1):751-5. https://doi.org/10.1016/S0022-3476(06)80021-1
  12. Shiao SY. Comparison of continuous versus intermittent sucking in very-low-birth-weight infants. J Obstet Gynecol Neonatal Nurs 1997;26:313-9. https://doi.org/10.1111/j.1552-6909.1997.tb02147.x
  13. Shiao SY, Youngblut JM, Anderson GC, DiFiore JM, Martin RJ. Nasogastric tube placement: effects on breathing and sucking in verylow-birth-weight infants. Nurs Res 1995;44:82-8.
  14. Chen CH, Wang TM, Chang HM, Chi CS. The effect of breast- and bottle-feeding on oxygen saturation and body temperature in preterm infants. J Hum Lact 2000;16:21-7. https://doi.org/10.1177/089033440001600105
  15. Farahani R, Kanaan A, Gavrialov O, Brunnert S, Douglas RM, Morcillo P, et al. Differential effects of chronic intermittent and chronic constant hypoxia on postnatal growth and development. Pediatr Pulmonol 2008;43:20-8. https://doi.org/10.1002/ppul.20729
  16. Garg M, Kurzner SI, Bautista DB, Keens TG. Clinically unsuspected hypoxia during sleep and feeding in infants with bronchopulmonary dysplasia. Pediatrics 1988;81:635-42.
  17. Gewolb IH, Vice FL. Neonatal rhythmic feeding score correlates with short-term neurodevelopmental outcome in premature infants ${\leq}$33 weeks gestation [abstract]. Pediatr Res 2005;57:3290.
  18. Samuels MP, Poets CF, Southall DP. Abnormal hypoxemia after lifethreatening events in infants born before term. J Pediatr 1994;125:441-6. https://doi.org/10.1016/S0022-3476(05)83292-5
  19. Le Souef PN, England SJ, Stogryn HA, Bryan AC. Comparison of diaphragmatic fatigue in newborn and older rabbits. J Appl Physiol (1985) 1988;65:1040-4. https://doi.org/10.1152/jappl.1988.65.3.1040
  20. Lopes JM, Muller NL, Bryan MH, Bryan AC. Synergistic behavior of inspiratory muscles after diaphragmatic fatigue in the newborn. J Appl Physiol Respir Environ Exerc Physiol 1981;51:547-51.
  21. Muller N, Gulston G, Cade D, Whitton J, Froese AB, Bryan MH, et al. Diaphragmatic muscle fatigue in the newborn. J Appl Physiol Respir Environ Exerc Physiol 1979;46:688-95.
  22. Gewolb IH, Vice FL. Abnormalities in the coordination of respiration and swallow in preterm infants with bronchopulmonary dysplasia. Dev Med Child Neurol 2006;48:595-9. https://doi.org/10.1017/S0012162206001241
  23. Wang LY, Luo HJ, Hsieh WS, Hsu CH, Hsu HC, Chen PS, et al. Severity of bronchopulmonary dysplasia and increased risk of feeding desaturation and growth delay in very low birth weight preterm infants. Pediatr Pulmonol 2010;45:165-73. https://doi.org/10.1002/ppul.21171
  24. Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001;163:1723-9. https://doi.org/10.1164/ajrccm.163.7.2011060
  25. Gewolb IH, Fishman D, Qureshi MA, Vice FL. Coordination of suckswallow-respiration in infants born to mothers with drug-abuse problems. Dev Med Child Neurol 2004;46:700-5.
  26. Gaultier C. Respiratory muscle function in infants. Eur Respir J 1995;8:150-3. https://doi.org/10.1183/09031936.95.08010150
  27. Jolley CJ, Luo YM, Steier J, Reilly C, Seymour J, Lunt A, et al. Neural respiratory drive in healthy subjects and in COPD. Eur Respir J 2009;33:289-97.
  28. Estrada L, Torres A, Sarlabous L, Jane R. Evaluating respiratory muscle activity using a wireless sensor platform. Conf Proc IEEE Eng Med Biol Soc 2016;2016:5769-72.
  29. Farina D, Enoka RM. Surface EMG decomposition requires an appropriate validation. J Neurophysiol 2011;105:981-2. https://doi.org/10.1152/jn.00855.2010
  30. Lunardi AC, Porras DC, Barbosa RC, Paisani DM, Marques da Silva CC, Tanaka C, et al. Effect of volume-oriented versus flow-oriented incentive spirometry on chest wall volumes, inspiratory muscle activity, and thoracoabdominal synchrony in the elderly. Respir Care 2014;59:420-6. https://doi.org/10.4187/respcare.02665
  31. Keens TG, Bryan AC, Levison H, Ianuzzo CD. Developmental pattern of muscle fiber types in human ventilatory muscles. J Appl Physiol Respir Environ Exerc Physiol 1978;44:909-13.
  32. Sieck GC, Fournier M, Blanco CE. Diaphragm muscle fatigue resistance during postnatal development. J Appl Physiol (1985) 1991;71:458-64. https://doi.org/10.1152/jappl.1991.71.2.458
  33. Bamford O, Taciak V, Gewolb IH. The relationship between rhythmic swallowing and breathing during suckle feeding in term neonates. Pediatr Res 1992;31:619-24. https://doi.org/10.1203/00006450-199206000-00016
  34. Gewolb IH, Bosma JF, Vice FL. Maturational changes in the coordination of respiration and swallow in premature infants with and without bronchopulmonary dysplasia (BPD) [abstract]. Pediatr Res 2002;51.
  35. Gewolb IH, Bosma JF, Taciak VL, Vice FL. Abnormal developmental patterns of suck and swallow rhythms during feeding in preterm infants with bronchopulmonary dysplasia. Dev Med Child Neurol 2001;43:454-9. https://doi.org/10.1017/S0012162201000834

Cited by

  1. The impact of preterm adversity on cardiorespiratory function vol.105, pp.1, 2018, https://doi.org/10.1113/ep087490
  2. Effects of Microcurrent on Oxygen Saturation by Controlling Rectus Abdominis Activity in Preterm Infant With Desaturation During Feeding: A Pilot Study vol.9, pp.None, 2021, https://doi.org/10.3389/fped.2021.694432
  3. Electromyographic activity of the sternocleidomastoid muscle in infants with bronchopulmonary dysplasia vol.37, pp.3, 2018, https://doi.org/10.1007/s42600-021-00169-w
  4. Ultrasound measurements of abdominal muscle thickness are associated with postmenstrual age at full oral feedings in preterm infants: A preliminary study vol.36, pp.6, 2018, https://doi.org/10.1002/ncp.10670