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1 Department of Pediatrics and Physiology, University of Sherbrooke, Sherbrooke, Quebec, Canada
2 Department of Gynecology and Obstetrics, University of Sherbrooke, Sherbrooke, Quebec, Canada
3 Department of Surgery, ENT, University of Sherbrooke, Sherbroooke, Quebec, Canada
4 Department of Pediatrics and Physiology, University of Sherbrooke, Sherbrooke, Quebec, Canada; Department of Surgery, ENT, University of Sherbrooke, Sherbroooke, Quebec, Canada
* To whom correspondence should be addressed. E-mail: Jp.Praud{at}USherbrooke.ca.
We previously reported that active glottal closure was present in 90% of spontaneous central apneas in premature lambs while maintaining a high apneic lung volume. The present study aimed at testing whether this mechanism limits post-apnea oxygen desaturation. Four premature lambs were instrumented for recording states of alertness, thyroarytenoid muscle and diaphragm electromyographic (EMG) activity, nasal airflow, lung volume changes and pulse oximetry. 1452 spontaneous central apneas (isolated or during periodic breathing) were analyzed in non-sedated lambs. Apneas, with high lung volume maintained by active glottal closure, were compared to apneas, with a tracheostomy opened at apnea onset. Oxygen desaturation slopes were lower when high apneic lung volume was actively maintained during both wakefulness and quiet sleep. Furthermore, oxygen desaturation slopes were lower following isolated apneas with continuous thyroarytenoid EMG during wakefulness, compared to apneas with non continuous TA EMG (=glottis opened shortly after apnea onset). These results highlight the importance of maintaining high alveolar oxygen stores during central apneas by active glottal closure to limit desaturation in newborns.
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