Maturation of respiratory reflex responses in the fetus and neonate.
Respiratory control in the fetus and neonate is quite immature when compared to that of adults. This immaturity involves all facets of respiration including respiratory responses to hypoxia, hypercapnia, an exaggerated apnoeic response to laryngeal stimulation and immature responses to activation of pulmonary afferents. The net result of this immaturity of breathing responses is the vulnerability of neonates and especially preterm infants to apnoea and respiratory pauses. The mechanisms behind immature control of breathing are not fully understood, but seem to originate from a predominance of inhibitory input early in life on respiratory centres. The relative contribution of up-regulation of inhibitory pathways versus down-regulation of excitatory ones is not clear. Multiple neurotransmitters have been implicated in the regulation of breathing in mammals and some of them are discussed in this chapter.
Abu-Shaweesh
Jalal M
JM
Department of Pediatrics, Case Western Reserve University, 11000 Euclid Ave, Cleveland, OH 44106, USA. jxa16@po.cwru.edu
D000138:Acidosis / Q000503:physiopathology; D000344:Afferent Pathways / Q000502:physiology; D000367:Age Factors; D000818:Animals; D001049:Apnea / Q000503:physiopathology; D005333:Fetus / Q000502:physiology*; D006801:Humans; D006935:Hypercapnia / Q000503:physiopathology; D000860:Hypoxia / Q000503:physiopathology; D007231:Infant, Newborn / Q000502:physiology*; D007820:Laryngeal Mucosa / Q000502:physiology; D007823:Laryngeal Nerves / Q000502:physiology; D008168:Lung / Q000294:innervation / Q000502:physiology; D018377:Neurotransmitter Agents / Q000502:physiology; D012018:Reflex / Q000502:physiology; D012119:Respiration; D012143:Respiratory Physiological Phenomena
D018377:Neurotransmitter Agents