In the present study covering the head with bed- ding resulted in accumulation of CO2 around the face, significantly less apneas, and shorter duration of apneas after sighs, higher heart and respiratory rates, and higher peripheral skin temperature at 21⁄2 and 5 months of age. At 21⁄2 months the infants also had more frequent body movements after being cov- ered. While covered, the prone position was associ- ated with higher CO2 levels close to the face, higher heart rates, peripheral skin temperatures, and slightly higher transcutaneous Pco2 than the supine position, and the infants were less able to remove the cover when prone.
The infants in the present study slept on a firm mattress with the face to the side, and the duvet (fiber quilt) used to cover the head is the cover in common use in Norway. The study condition of totally covering the head was chosen to mimic the circumstances in which SIDS victims are commonly found.14 The observed CO2 concentrations at the face while the head was covered were similar to those observed by Chiodini et al11 in uncovered infants sleeping face down on soft bedding, but greater than the levels of .3 to 2.0% observed by Malcolm et al12 in prone infants whose heads were covered with a baby blanket. The higher CO2 levels in the present com- pared with the latter study probably reflect a higher resistance to transport of gases through the duvet than a blanket, and possibly a greater difficulty in creating air channels to the surrounding air attribut- able to the heavier weight of the duvet. The range of CO2 accumulation measured around the face during the first 15 minutes of the study was comparable to the values obtained during the first 5 minutes in an experimental CO2 rebreathing model.10 Lack of fur- ther rise probably reflected the establishment of channels from spontaneous lifting of the duvet with subsequent exchange of air to the surroundings. Hy- percapnia is known to be a strong respiratory and arousal stimulant in normal infants.23 In this study, the immediate increases in respiratory rate, number of body movements and arousals, and fewer apneas and shorter duration of apneas after sighs after cov- ering the head, are consistent with such an effect of CO2. Although not always significant, the rise in oxygen saturation and transcutaneous Po2, and only a minimal rise in transcutaneous Pco2 further indi- cate that normal infants are able to eliminate CO2 immediately by hyperventilation.
ในการศึกษาปัจจุบัน ครอบคลุมศีรษะ ด้วยเตียงดิงผลในการสะสมของ CO2 รอบ ๆ ใบหน้า apneas อย่างมีนัยสำคัญน้อยกว่า และระยะเวลาที่สั้นลงของ apneas sighs ระดับสูง และอัตราการหายใจ และสูงกว่าอุณหภูมิผิวอุปกรณ์ต่อพ่วง ที่ 21⁄2 และอายุ 5 เดือน ที่ 21⁄2 เดือน ทารกยังได้เคลื่อนไหวร่างกายบ่อยกว่าถูก cov ered ในขณะที่ครอบคลุม ตำแหน่งที่เส้น associ ระดับ CO2 สูงหน้า ราคาห้องพักสูง อุณหภูมิผิวอุปกรณ์ต่อพ่วง และ Pco2 transcutaneous สูงขึ้นเล็กน้อยกว่าตำแหน่ง supine และทารกมีความสามารถน้อยเอาปะเมื่อแนวโน้มThe infants in the present study slept on a firm mattress with the face to the side, and the duvet (fiber quilt) used to cover the head is the cover in common use in Norway. The study condition of totally covering the head was chosen to mimic the circumstances in which SIDS victims are commonly found.14 The observed CO2 concentrations at the face while the head was covered were similar to those observed by Chiodini et al11 in uncovered infants sleeping face down on soft bedding, but greater than the levels of .3 to 2.0% observed by Malcolm et al12 in prone infants whose heads were covered with a baby blanket. The higher CO2 levels in the present com- pared with the latter study probably reflect a higher resistance to transport of gases through the duvet than a blanket, and possibly a greater difficulty in creating air channels to the surrounding air attribut- able to the heavier weight of the duvet. The range of CO2 accumulation measured around the face during the first 15 minutes of the study was comparable to the values obtained during the first 5 minutes in an experimental CO2 rebreathing model.10 Lack of fur- ther rise probably reflected the establishment of channels from spontaneous lifting of the duvet with subsequent exchange of air to the surroundings. Hy- percapnia is known to be a strong respiratory and arousal stimulant in normal infants.23 In this study, the immediate increases in respiratory rate, number of body movements and arousals, and fewer apneas and shorter duration of apneas after sighs after cov- ering the head, are consistent with such an effect of CO2. Although not always significant, the rise in oxygen saturation and transcutaneous Po2, and only a minimal rise in transcutaneous Pco2 further indi- cate that normal infants are able to eliminate CO2 immediately by hyperventilation.
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