Abstract

BackgroundThe laryngeal chemoreflex exists in infants as a primary sensory mechanism for defending the airway from the aspiration of liquids. Previous studies have hypothesized that prolonged apnea associated with this reflex may be life threatening and might be a cause of sudden infant death syndrome.MethodsIn this study we quantified the output of the respiratory neural network, the diaphragm EMG signal, during the laryngeal chemoreflex and eupnea in early postnatal (3–10 days) piglets. We tested the hypothesis that diaphragm EMG activity corresponding to reflex-related events involved in clearance (restorative) mechanisms such as cough and swallow exhibit lower complexity, suggesting that a synchronized homogeneous group of neurons in the central respiratory network are active during these events. Nonlinear dynamic analysis was performed using the approximate entropy to asses the complexity of respiratory patterns.ResultsDiaphragm EMG, genioglossal activity EMG, as well as other physiological signals (tracheal pressure, blood pressure and respiratory volume) were recorded from 5 unanesthetized chronically instrumented intact piglets. Approximate entropy values of the EMG during cough and swallow were found significantly (p < 0.05 and p < 0.01 respectively) lower than those of eupneic EMG.ConclusionReduced complexity values of the respiratory neural network output corresponding to coughs and swallows suggest synchronous neural activity of a homogeneous group of neurons. The higher complexity values exhibited by eupneic respiratory activity are the result of a more random behaviour, which is the outcome of the integrated action of several groups of neurons involved in the respiratory neural network.

Highlights

  • The laryngeal chemoreflex exists in infants as a primary sensory mechanism for defending the airway from the aspiration of liquids

  • In recent studies we have investigated the complexity of respiratory patterns during eupnea and hypoxia using nonlinear dynamic analysis and time-frequency analysis of the phrenic neurogram during early maturation [7,8]

  • Our objective in this study was the investigation of changes in the complexity of the central respiratory network of the piglets during the laryngeal chemoreflex (LCR)

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Summary

Introduction

The laryngeal chemoreflex exists in infants as a primary sensory mechanism for defending the airway from the aspiration of liquids. Previous studies have hypothesized that prolonged apnea associated with this reflex may be life threatening and might be a cause of sudden infant death syndrome. The laryngeal chemoreflex (LCR) has been investigated in many epidemiological and physiological studies as a putative exogenous stressor that may contribute to the pathogenesis of sudden infant death syndrome (SIDS) [1-. The manifestations of LCR consist of swallowing and coughing, which occur frequently, apnea (usually associated with bradycardia), startle, laryngeal constriction and arousal from sleep. Previous studies indicated apnea duration to be strongly influenced by the stimulus type (water being much more effective than saline solutions) but even more by a central neural mechanism that perpetuates respiratory depression, altered central neural processing of receptor input being a highly relevant factor [6]. The whole LCR duration was found to be prolonged by vulnerabilities of the neurons in the rostral ventral medulla (RVM) and to enhance the disruption of stable respiratory patterns within this context, strengthening its relevance in SIDS [1]

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