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M M Seshia

Publications and source records attributed to M M Seshia.

21 records · Page 2Linked to original sources

The effect of gestational age on the effective elastance of the respiratory system in neonates.

We measured the effective elastance of the respiratory system (E'RS) in 38 "healthy" neonates, gestational ages ranging from 28-42 weeks. E'RS was calculated by dividing the inspiratory pressure generated after nasal occlusion by the tidal volume of the breath preceding occlusion (E'RS = P/VT). E'RS decreased from 790 +/- 0.070 cm H2O/liter at 30.4 +/- 0.4 weeks of gestation to 520 +/- 0.030 at 34.5 +/- 0.3 weeks (P less than 0.01); then to 340 +/- 0.020 at 40 +/- 0.2 weeks (P less than 0.01). E'RS corrected for lung volume ("specific" E'RS) were 32 +/- 2,32 +/- 4, and 28 +/- 2 cm H2O at the above gestational ages, respectively (P greater than 0.05). We suggest: (1) the increased E'RS observed in preterm infants is lung volume dependent. Changes in lung volume may alter the geometry of the thorax, and therefore, the force/length characteristics of the respiratory muscles; (2) this increased E'RS is not of much benefit to preterm infants who have little respiratory stability when E'RS is maximum; and (3) if E'RS is an index of mechanical stability, apnea in preterm infants is independent of the mechanical properties of the respiratory system.

Gestational Age↗

Effects of CO2 on immediate ventilatory response to O2 in preterm infants.

We wanted to know wheter the paradoxical response to CO2 under various background concentrations of O2 in preterm infants was mediated at the peripheral chemoreceptors. In five preterm infants we estimated peripheral chemoreceptor activity using the immediate change in ventilation (first 30 s) when 15%, 40%, 60%, or 100% O2 was substituted for 21% O2. Potentiation between O2 and CO2 was assessed by comparing the response with and without 4% CO2. CO2 enhanced the immediate hyperventilation with hypoxia (P less than 0.005) and reduced the immediate hypoventilation with hyperoxia (P less than 0.025 for 40% O2). This effect of CO2 increased from .00% to 15% O2 (P less than 0.05). These findings suggest: 1) CO2 interacts with O2 at the peripheral chemoreceptor level, and 2) because this interaction is more pronounced with hypoxia, the flatter CO2 response we observed with hypoxia was probably not mediated through the peripheral chemoreceptors and is likely to be central in origin.

Carbon Dioxide↗