Periodic breathing and oxygen saturation in preterm infants at discharge.

OBJECTIVE

Periodic breathing (PB) is a common respiratory pattern in preterm infants. Our aim was to determine the influence of PB on the pattern of oxygenation in preterm infants with significant PB at discharge from hospital.

STUDY

DESIGN

Overnight 12-hour recordings of arterial O(2) saturation (SpO(2)), impedance breathing movement, nasal thermistor signals for airflow, and heart rate were performed in all preterm infants < or = 34 weeks' gestational age at birth, prior to hospital discharge. Infants had recovered from their neonatal complications and were not receiving methylxanthines or supplemental oxygen. Data from 28 infants who had significant PB (> or = 5% of quiet time artifact free) were further analyzed. Gestational age at birth was (median, range) 32 (27-34) weeks, and gestational age at recording was 35 (33-37) weeks.

RESULTS

The baseline SpO(2) was 98% (92-100%). During PB, all infants had episodes when SpO(2) fell > or = 5%, and all except one had episodes when SpO(2) was < 90%. Sixty episodes of prolonged desaturation (SpO(2) < or = 80% for >/ or = 4 seconds) were recorded in 10 infants: 31 occurred during PB, 16 during hypopnea, 10 during apnea, and 3 occurred in the absence of these breathing patterns. During PB, nine infants (32%) had 1 to 13 episodes of prolonged desaturation, lasting 9 (4-76) seconds.

CONCLUSION

We conclude that PB is a common cause of prolonged desaturation in preterm infants at discharge.