Clinically relevant apneas, which are common in preterm infants, may adversely affect later neuropsychological condition in this group of patients. Pharmacotherapy to stimulate respiratory functions may be unsuccessful. Polygraphic recording may help in the differential diagnosis of these clinically relevant events. Twenty-nine preterm neonates born before 36 weeks of gestational age were examined using polygraphic recording (respiration--two channels, perioral electromyography, oxygen saturation, heart rate, electroencephalography, electrocardiography, electrooculography). The examination was ordered by the attending physician after an unsuccessful treatment of apnea by Aminophylline, and it should contribute to the clarification of the causes of these events. In the course of the polygraphic examinations, altogether 63 episodes were recorded during which the pulse oximeter alarm signal was set off. In 42 cases, the alarm signal was set off in events during which SaO(2) fell below 85%. In the remaining 21 cases, the alarm signal was set off in episodes during which early bradycardia below 90/min occurred. The onset of apnea was very often associated with the phasic increase of the perioral electromyography and with electroencephalography arousal reaction. Because of suspicion that these apneas may be triggered by episodes of gastroesophageal reflux, the interruption of the Aminophylline treatment and setting up an antireflux regimen were recommended. These therapeutic measures had a positive effect: The frequency of alarm signals decreased within 48 h by a statistically significant 50%. In cases where the pharmacotherapy of apnea by stimulation of respiratory functions is not successful, differential diagnostic analysis should be performed. Polygraphy may contribute to the clarification of the causes underlying clinically relevant apneas in a view of newly described polygraphic signs. It is feasible to suspect, based on these signs, that gastroesophageal reflux is the cause for clinically significant apneas in that case.

• MeSH
• Apgar skóre MeSH
• apnoe etiologie   MeSH
• arousal fyziologie   MeSH
• diferenciální diagnóza MeSH
• elektroencefalografie MeSH
• elektrokardiografie MeSH
• elektromyografie MeSH
• gastroezofageální reflux vrozené   diagnóza   MeSH
• jednotky intenzivní péče o novorozence MeSH
• kyslík krev   MeSH
• lidé MeSH
• monitorování fyziologických funkcí MeSH
• nemoci nedonošenců diagnóza   MeSH
• novorozenec MeSH
• porodní hmotnost MeSH
• spánková apnoe centrální diagnóza   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• novorozenec MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kyslík MeSH

Two patients with congenital atresia of the left coronary artery ostium underwent myocardial revascularization at the age of three years and three months, respectively. The patients were admitted to the hospital with a clinical history of sudden chest pain or short apnea not necessitating resuscitation. Non-invasive examinations and hemodynamic studies revealed dysfunction of the left ventricle and ostial atresia of the left coronary artery. Surgical revascularization-bypass grafts were performed using the left internal mammary artery and saphenous vein graft in the first case and the left internal mammary artery in the second child. Both patients survived surgery and good patency of the grafts was confirmed by coronary angiograms during hospital stay. These cases are interesting because of their rarity and diagnostic and therapeutic difficulties.

• MeSH
• angina pectoris etiologie   chirurgie   MeSH
• anomálie koronárních cév komplikace   patologie   patofyziologie   chirurgie   MeSH
• apnoe etiologie   chirurgie   MeSH
• funkce levé komory srdeční MeSH
• kojenec MeSH
• koronární angiografie MeSH
• koronární bypass * MeSH
• koronární cévy patologie   patofyziologie   chirurgie   MeSH
• lidé MeSH
• předškolní dítě MeSH
• průchodnost cév MeSH
• vena saphena transplantace   MeSH
• výsledek terapie MeSH
• Check Tag
• kojenec MeSH
• lidé MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Various cardiorespiratory and electrophysiological parameters were analysed in a model of acute respiratory failure induced by inhalation of pure nitrogen in approximately 150 anaesthetized cats. Initial hyperventilation leading to apnoea was characterized by extreme hypoxaemia, marked bradycardia and flattening of electrocortical (ECoG) activity. Artificial ventilation applied at the stage of marked mydriasis usually spontaneously prevented cardiovascular failure and normalized vital functions. Up to seven successive apnoeic attacks could be induced in the same cat. During the first 30 or 60 s of apnoea, nasopharyngeal stimulation usually elicited a typical gasp-like aspiration reflex, while tracheobronchial stimulation provoked a weak cough only in 28 and 34% of cases for 30- and 60-s apnoea, respectively. The aspiration reflex could be elicited at very low and even isoelectric ECoG activity, and its periodic provocation (without artificial ventilation) resulted, more frequently than did gasping, in recovery from hypoxic apnoea. Arousal and resuscitation induced by the aspiration reflex can provide a useful model to study the mechanisms of reversible respiratory failure and restitution of vital functions.

• MeSH
• anestezie MeSH
• aplikace inhalační MeSH
• apnoe etiologie   terapie   MeSH
• dusík MeSH
• elektrokardiografie MeSH
• fyzikální stimulace MeSH
• hypoxie etiologie   terapie   MeSH
• kočky MeSH
• modely nemocí na zvířatech MeSH
• nadechnutí fyziologie   MeSH
• nazofarynx MeSH
• reflex fyziologie   MeSH
• respirační insuficience etiologie   terapie   MeSH
• resuscitace metody   MeSH
• zvířata MeSH
• Check Tag
• kočky MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• dusík MeSH

Experiments were carried out on 16 anaesthetized, non-paralysed cats to determine the effects of unilateral, successive focal cooling of the nuclei of the dorsal and ventral respiratory groups (DRG, VRG) of the medulla oblongata on quiet breathing parameters. The results of cold block tests of the respiratory nuclei showed that: 1. Compared with the control state, cooling of the ventrolateral part of the nucleus solitarii (vl. NTS) and the rostral part of the nucleus retroambigualis (r. NRA) to 20 degrees C or 15 degrees C decreased the respiration rate (p less than 0.001), prolonged the inspiration time (p less than 0.01 and p less than 0.001 respectively) and the development of apneustic breathing. A decrease in the inspiratory pleural pressure values (p less than 0.01) was found after cooling the r. NRA region to 15 degrees C. In 45% of the cases of cooling of the vl. NTS and 66.7% of cooling of the r. NRA to 15 degrees C, an incidence of short inspiratory efforts was observed. 2. Focal cooling of the nucleus retrofacialis (nucl. RF) region to 20 degrees C always arrested rhythmic respiration. 3. The effects of unilateral focal cooling of the respiratory nuclei were always bilaterally symmetrical and, after discontinuing cooling, reversible. 4. The findings indicate that the inspiratory neurones of the r. NRA participate more in regulation of the intensity of inspiration than those of the vl. NTS, while the nucl. RF region may be a part of central regulatory mechanisms essential for the maintenance of rhythmic breathing in cats.

• MeSH
• apnoe etiologie   MeSH
• dýchání * MeSH
• kočky MeSH
• medulla oblongata fyziologie   MeSH
• nervus phrenicus MeSH
• terapeutická hypotermie * metody   MeSH
• zvířata MeSH
• Check Tag
• kočky MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH

Changes in the respiratory frequency and heart rate in response to 10 seconds' inflation of the lungs with oxygen by the CPAP method were studied in 32 premature neonates. Elevation of the pressure in the airways and lungs of 0.25, 0.49, 0.73 and 0.98 kPa led to a slower respiration rate or to apnoea. The incidence of apnoea rose in proportion to the pressure. When inflation was started, forced inspiratory efforts (a gasp reflex) occurred. The incidence of the efforts was higher at higher inflation pressures, but their intensity was not correlated to the size of the pressure. They were manifested in a drop in oesophageal pressure to a mean -2.0 +/- 0.2 kPa and their mean duration was 169 +/- 8 ms. The administration of oxygen without an increase in pressure produced neither apnoea nor forced inspiratory reactions. Neither an increase in the pressure in the airways and lungs to the above values, nor the plain administration of oxygen, produced any significant changes in the instantaneous heart rate.

• MeSH
• apnoe etiologie   MeSH
• atmosférický tlak MeSH
• dýchání * MeSH
• hyperbarická oxygenace škodlivé účinky   MeSH
• kyslík aplikace a dávkování   MeSH
• lidé MeSH
• nemoci novorozenců etiologie   MeSH
• novorozenec nedonošený * MeSH
• novorozenec MeSH
• srdeční frekvence * MeSH
• Check Tag
• lidé MeSH
• novorozenec MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• kyslík MeSH

• Klíčová slova
• ANESTHESIA, GENERAL/complications *, APNEA/etiology *, NEOMYCIN/toxicology *,
• MeSH
• anestezie * MeSH
• apnoe etiologie   MeSH
• celková anestezie komplikace   MeSH
• lidé MeSH
• neomycin toxicita   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• neomycin MeSH

• Klíčová slova
• APNEA/etiology *, NEOMYCIN/toxicology *,
• MeSH
• apnoe etiologie   MeSH
• neomycin toxicita   MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• neomycin MeSH