Developmental changes in upper airway dynamics

Developmental changes in upper airway dynamics

Author Marcus, Carole L. Google Scholar
Prado, Lucila Bizari Fernandes do Autor UNIFESP Google Scholar
Lutz, Janita Google Scholar
Katz, Eliot S. Google Scholar
Black, Cheryl A. Google Scholar
Galster, Patricia Google Scholar
Carson, Kathryn A. Google Scholar
Institution Johns Hopkins Univ
Universidade Federal de São Paulo (UNIFESP)
Abstract Normal children have a less collapsible upper airway in response to subatmospheric pressure administration (P-NEG) during steep than normal adults do, and this upper airway response appears to be modulated by the central ventilatory drive. Children have a greater ventilatory drive than adults. We, therefore, hypothesized that children have increased neuromotor activation of their pharyngeal airway during sleep compared with adults. As infants have few obstructive apneas during steep, we hypothesized that infants would have an upper airway that was resistant to collapse. We, therefore, compared the upper airway pressure-flow (V) relationship during sleep between normal infants, prepubertal children, and adults. We evaluated the upper airway response to 1) intermittent, acute P-NEG (infants, children, and adults), and 2) hypercapnia (children and adults). We found that adults had a more collapsible upper airway during sleep than either infants or children. the children exhibited a vigorous response to both P-NEG and hypercapnia during sleep (P < 0.01), whereas adults had no significant change. Infants had an airway that was resistant to collapse and showed a very rapid response to P-NEG. We conclude that the upper airway is resistant to collapse during sleep in infants and children. Normal children have preservation of upper airway responses to P-NEG and hypercapnia during sleep, whereas responses are diminished in adults. Infants appear to have a different pattern of upper airway activation than older children. We speculate that the pharyngeal airway responses present in normal children are a compensatory response for a relatively narrow upper airway.
Keywords sleep-disordered breathing
critical pressure
upper airway collapsibility
Language English
Date 2004-07-01
Published in Journal of Applied Physiology. Bethesda: Amer Physiological Soc, v. 97, n. 1, p. 98-108, 2004.
ISSN 8750-7587 (Sherpa/Romeo, impact factor)
Publisher Amer Physiological Soc
Extent 98-108
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000222310700014

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