Influence of radiofrequency electromagnetic fields exposure on sleep patterns in preterm neonates.

PURPOSE: The study objective was to assess the influence of radiofrequency electromagnetic fields (RF-EMF) exposure on sleep patterns in preterm newborns. We hypothesized that an increase in RF-EMF exposure levels would alter infants' sleep structure parameters. MATERIALS AND METHODS: Individual, continuous measurements of RF-EMF levels were performed in 29 hospitalized preterm newborns throughout the first 21 days after birth. The last day, overnight sleep structure was recorded by polysomnography. Relationships between both chronic (three-week period) and acute (polysomnographic period) RF-EMF levels with sleep parameters were computed. RESULTS: At median levels, the main chronic effect was an increase in indeterminate sleep with RF-EMF exposure. At the highest exposure levels found in our study, an increase in RF-EMF levels increased sleep fragmentation. No significant relationship was found between acute RF-EMF levels and sleep parameters. CONCLUSIONS: Despite no consolidated disruption in sleep structure, this study is the first to show that some sleep parameters seem to have a certain sensitivity to chronic - but not acute - RF-EMF exposure in preterm newborns. Further studies are needed to confirm our results and examine possible mid- to long-term, sleep-related cardiorespiratory and neurodevelopmental outcomes.

Hot water immersion: Maintaining core body temperature above 38.5°C mitigates muscle fatigue.

PURPOSE: Hot water immersion (HWI) has gained popularity to promote muscle recovery, despite limited data on the optimal heat dose. The purpose of this study was to compare the responses of two exogenous heat strains on core body temperature, hemodynamic adjustments, and key functional markers of muscle recovery following exercise-induced muscle damage (EIMD). METHODS: Twenty-eight physically active males completed an individually tailored EIMD protocol immediately followed by one of the following recovery interventions: HWI (40°C, HWI40 ), HWI (41°C, HWI41 ) or warm water immersion (36°C, CON36 ). Gastrointestinal temperature (Tgi ), hemodynamic adjustments (cardiac output [CO], mean arterial pressure [MAP], and systemic vascular resistance [SVR]), pre-frontal cortex deoxyhemoglobin (HHb), ECG-derived respiratory frequency, and subjective perceptual measures were tracked throughout immersion. In addition, functional markers of muscle fatigue (maximal concentric peak torque [Tpeak ]) and muscle damage (late-phase rate of force development [RFD100-200 ]) were measured prior to EIMD (pre-), 24 h (post-24 h), and 48 h (post-48 h) post-EIMD. RESULTS: By the end of immersion, HWI41 led to significantly higher Tgi values than HWI40 (38.8 ± 0.1 vs. 38.0°C ± 0.6°C, p < 0.001). While MAP was well maintained throughout immersion, only HWI41 led to increased (HHb) (+4.2 ± 1.47 µM; p = 0.005) and respiratory frequency (+4.0 ± 1.21 breath.min-1 ; p = 0.032). Only HWI41 mitigated the decline in RFD100-200 at post-24 h (-7.1 ± 31.8%; p = 0.63) and Tpeak at post-48 h (-3.1 ± 4.3%, p = 1). CONCLUSION: In physically active males, maintaining a core body temperature of ~25 min within the range of 38.5°C-39°C has been found to be effective in improving muscle recovery, while minimizing the risk of excessive physiological heat strain.

Sex-dependent impact of perinatal 5G electromagnetic field exposure in the adolescent rat behavior.

The fifth generation (5G) network is currently being worldwide spread out, raising questions about the potential impact of this new technology, particularly on immature organisms. The current study aimed to investigate the effects of daily 5G electromagnetic field (EMF) perinatal exposure on the neurodevelopment of rats. The exposure level was set to the limit of whole-body public exposure defined by the International Commission on Non-Ionizing Radiation Protection. The mother rat specific absorption rate (SAR) was 0.07 W/kg for 22 h/day at 3500 MHz continuous wave from gestational day (GD) 8 to post-natal day (PND) 21. Clinical observations were performed on weight, length, sex ratio, number of pups per litter, and number of stillborn in sham and EMF-exposed groups (n = 7). The age of pinna ear detachment, incisor eruption, and eye opening were recorded. Behavior was assessed on righting, gripping, and negative geotaxis reflexes at PND 3 or 7 and on stereotyped and horizontal movements in the open field at PND 43. Our results indicated that both male and female pups showed delayed incisor eruption in the EMF-exposed group compared to the sham group (+ 1 day). Regarding activity in the open field, adolescent females showed less stereotyped movements (- 70%), while adolescent males showed more stereotyped movements (+ 50%) compared to the sham-exposed adolescent rats. Thus, the present study suggested that perinatal exposure to 5G at SAR level below reglementary threshold led to perturbations in the descendants seen in juveniles and adolescents.

How to Control Exposure to Fifth-Generation Radiofrequencies in Preterm Newborns in Incubator.

Infant and family centered development care reduces infant distress and supports the parent and infant's individual abilities. However, a new environmental factor is daily encountered: the radiofrequency electromagnetic fields (RF EMFs) with the most recent fifth-generation (5G) technology. Currently, the effects of RF EMF during development are discussed in animal models. The neonatal intensive care units are not spared from this stressor. The objective of this study was to evaluate the efficacy of a novel, electromagnetically insulating incubator cover to prevent the preterm infant from RF EMF exposure. A personal dosimeter was placed on the mattress of a closed incubator. Periods of exposure to low, medium, and high levels of 5G RF were delivered in the presence or absence of the incubator cover. The use of a silver-copper cover reduced the intensity of 5G radiofrequency levels from 52% to 57% (p < 0.0001), allowing to easily apply the precautionary principle.

Effect of daily co-exposure to inulin and chlorpyrifos on selected microbiota endpoints in the SHIME® model.

The intestinal microbiota has a key role in human health via the interaction with the somatic and immune cells in the digestive tract environment. Food, through matrix effect, nutrient and non-nutrient molecules, is a key regulator of microbiota diversity. As a food contaminant, the pesticide chlorpyrifos (CPF) has an effect on the composition of the intestinal microbiota and induces perturbation of microbiota. Prebiotics (and notably inulin) are known for their ability to promote an equilibrium of the microbiota that favours saccharolytic bacteria. The SHIME® dynamic in vitro model of the human intestine was exposed to CPF and inulin concomitantly for 30 days, in order to assess variations in both the bacterial populations and their metabolites. Various analyses of the microbiota (notably temporal temperature gradient gel electrophoresis) revealed a protective effect of the prebiotic through inhibition of the enterobacterial (E. coli) population. Bifidobacteria were only temporarily inhibited at D15 and recovered at D30. Although other potentially beneficial populations (lactobacilli) were not greatly modified, their activity and that of the saccharolytic bacteria in general were highlighted by an increase in levels of short-chain fatty acids and more specifically butyrate. Given the known role of host-microbiota communication, CPF's impact on the body's homeostasis remains to be determined.

The newborn infant's thermal environment in the delivery room when skin-to-skin care has to be interrupted.

OBJECTIVE: Newborns are prone to hypothermia immediately following birth. Hypothermia is associated with increased morbidity and mortality rates. We sought to assess the thermal environment and metabolic costs associated with exposure to various situations in the delivery room when skin-to-skin care (SSC) has to be curtailed. METHODS: Environmental variables (air temperature: Ta; relative humidity: RH; radiative temperature: Tr; and air convection velocity) were recorded during sequences reproducing SSC, in the maternity unit's various rooms ("passive environments") and in incubators ("active environments"). Analytical calorimetry was then used to calculate the body heat loss (BHL) from these data. RESULTS: The analysis of 1280 measurements of Ta, RH, Tr, and air convection velocity in SSC, passive and active environments revealed that (i) the thermohygrometric environment during SSC was optimal (Ta: 32.7 ± 3.2 °C; RH: 50.9 ± 5.6%), (ii) BHL rose when SSC had to be interrupted, and (iii) the use of a radiant incubator prevented hypothermia and reduced dry BHL but not humid BHL (9.4 ± 1.5 kcal/kg/h; p < .001), relative to SSC (5.8 ± 2.0 kcal/kg/h; p < .001). CONCLUSION: The newborn infant's thermohygrometric environment is optimal during SSC in the delivery room. When SSC was interrupted, Ta and RH always decreased, and BHL increased in all passive environments.

Optimization of the incubator air temperature during LED phototherapy treatment for the preterm infant.

Light-emitting diode phototherapy treatment for jaundice of the preterm infant presents adverse effects, such as discomfort, changes in metabolism, and overheating. This study quantified the body heat exchanges between the environment and a simulated preterm infant requiring phototherapy treatment in a closed incubator. Phototherapy treatment increased the mean incubator roof temperature by 2.9 °C (p < 0.001) and the incubator air temperature by 1 °C (p < 0.001). Analytical calorimetry was used to calculate the additional energy received during phototherapy and thus deduce the optimal incubator air temperature for ensuring thermoneutrality and preventing hyperthermia. The optimal air temperature settings inside the incubator during phototherapy were - 0.51 to - 1.25 °C lower than references, for preterm infant weighing 500 to 2000 g.Conclusion: Phototherapy treatment for jaundice of the preterm infant increased the incubator air temperature. To prevent overheating in the preterm during phototherapy, new curves for optimal air temperature settings inside the incubator were calculated with analytic calorimetry. What is Known •Phototherapy treatment is the first-line treatment for jaundice in the preterm infant. •Phototherapy treatment increases the risk of overheating. What is New •The heat transfers and risk of overheating were quantified using a thermal manikin during phototherapy treatment. •Phototherapy treatment increased the incubator roof temperature and heat transfers. •New incubator's air temperature settings during phototherapy treatment were calculated with analytical calorimetry for preterm infant weighing 500-2000 g.

Does the perigestational exposure to chlorpyrifos and/or high-fat diet affect respiratory parameters and diaphragmatic muscle contractility in young rats?

The perinatal period is characterized by developmental stages with high sensitivity to environmental factors. Among the risk factors, maternal High-Fat Diet (HFD) consumption and early-life pesticide exposure can induce metabolic disorders at adulthood. We established the effects of perigestational exposure to Chlorpyrifos (CPF) and/or HFD on respiratory parameters, sleep apnea and diaphragm contractility in adult rats. Four groups of female rats were exposed starting from 4 months before gestation till the end of lactation period to CPF (1 mg/kg/day vs. vehicle) with or without HFD. Sleep apnea and respiratory parameters were measured by whole-body plethysmography in male offspring at postnatal day 60. Then diaphragm strips were dissected for the measurement of contractility, acetylcholinesterase (AChE) activity, and gene expression. The perigestational exposure to CPF and/or HFD increased the sleep apnea index but decreased the respiratory frequency. The twitch tension and the fatigability index were also increased, associated with reduced AChE activity and elevated mRNA expression of AChE, ryanodine receptor, and myosin heavy chain isoforms. Therefore, the perigestational exposure to either CPF and/or HFD could program the risks for altered ventilatory parameters and diaphragm contractility in young adult offspring despite the lack of direct contact to CPF and/or HFD.

Effect of non-thermal radiofrequency on body temperature in mice.

Communication technologies based on radiofrequency (RF) propagation bring great benefits to our daily life. However, their rapid expansion raises concerns about possible impacts on public health. At intensity levels below the threshold to produce thermal effects, RF exposure has also recently been reported to elicit biological effects, resembling reactions to cold. The objective of the present study was to investigate the effects of non-thermal RF on body temperature in mice and the related mechanisms. 3-months-old C57BL/6 J mice were exposed to a continuous RF signal at 900 MHz, 20 ± 5 V.m-1 for 7 consecutive days, twice per day during the light phase, for one hour each time. The SAR was 0.16 ± 0.10 W.kg-1. We showed that body temperature patterns in mice change synchronously with the RF exposure periods. Average body temperature in the light phase in the exposed group was higher than in the control group. The expression of the TRPM8 gene was not affected by RF in trigeminal ganglia. Furthermore, the injection of a TRPM8 antagonist did not induce a temperature decrease in exposed mice, as this was the case for sham-controls. These findings indicate that 900 MHz RF exposure at non-thermal level produce a physiological effect on body temperature in mice. However, the involvement of TRPM8 receptors in the mechanism by which RF induced changes in body temperature of mice which remains to be further explored. It must then be assessed if this effect is extrapolable to man, and if this could lead to consequences on health.

Environmental radiofrequency electromagnetic field levels in a department of pediatrics.

Preterm neonates constitute a vulnerable population that is highly sensitive to its environment. Given the increased use of wireless communication devices (mobile and digital enhanced cordless telecommunications, WiFi networks, etc.), neonates hospitalized in a department of pediatrics are potentially exposed to radiofrequency electromagnetic fields (RF-EMF). Strikingly, data on RF-EMF levels in pediatric units have not previously been published. The objective of the present study was thus to quantify the RF-EMF levels in a 34-bed tertiary department of pediatrics with a neonatal critical care unit (NCCU) and a neonatal intensive care unit (NICU). To this end, we used triaxle antenna dosimeters to map the RF-EMF levels in the environment and to measure spot emissions from medical devices. In a first set of experiments, RF-EMF levels at 144 points in the staff area and in the children's rooms in the NCCU and NICU were evaluated over a 24-h period. In a second set of measurements performed in a Faraday chamber, we measured the RF-EMF levels emitted by the medical devices to which neonates are potentially exposed in the department of pediatrics. The RF-EMF levels were significantly higher in the NCCU than in the NICU (p < 0.05). Although the two units did not differ significantly with regard to the average maximum values, the single greatest value recorded in the NCCU (6 V/m GSM + UMTS 900 (UL) frequency band, in the staff area) was more than twice that recorded in the NICU (3.70 V/m in the UMTS 2100 (UL) frequency band, in the children's rooms). The NCCU and NICU did not differ significantly with regard to the time during which the RF-EMF level at each measurement point was more than two standard deviations above its mean. The RF-EMF level was significantly higher during the day than during the night (p < 0.001). The various medical devices used in the NICU did not emit detectable amounts of RF. Overall, RF-EMF levels in the NCCU and NICU were very low. It is probable that the RF-EMFs measured here were primarily generated by the parents' and staff members' activities, rather than by medical devices. However, a combination of low-level, chronic exposure with transient, elevated peak values in a vulnerable population of preterm neonates may be of particular concern. In a department of pediatrics, decreasing preterm neonates' exposure to RF-EMFs should primarily involve a limitation on the use of wireless communication devices by staff members and parents.

Effects of co-exposure to 900 MHz radiofrequency electromagnetic fields and high-level noise on sleep, weight, and food intake parameters in juvenile rats.

OBJECTIVE: Electrohypersensitive people attribute various symptoms to exposure of radiofrequency electromagnetic fields (RF-EMF); sleep disturbance is the most frequently cited. However, laboratory experiments have yielded conflicting results regarding sleep alterations. Our hypothesis was that exposure to RF-EMF alone would lead to slight or non-significant effects but that co-exposure to RF-EMFs and other environmental constraints (such as noise) would lead to significant effects. METHODS: 3-week-old male Wistar rats (4 groups, n = 12 per group) were exposed for 5 weeks to continuous RF-EMF (900 MHz, 1.8 V/m, SAR = 30 mW/kg) in the presence or absence of high-level noise (87.5 dB, 50-20000 Hz) during the rest period. After 5 weeks of exposure, sleep (24 h recording), food and water intakes, and body weight were recorded with or without RF-EMF and/or noise. At the end of this recording period, sleep was scored during the 1 h resttime in the absence of noise and of RF-EMF exposure. RESULTS: Exposure to RF-EMF and/or noise was associated with body weight gain, with hyperphagia in the noise-only and RF-EMF + noise groups and hypophagia in the RF-EMF-only group. Sleep parameters recording over 24 h highlighted a higher frequency of active wakefulness in the RF-EMF-only group and a lower non-rapid eye movement/rapid eye movement sleep ratio during the active period in the noise-only group. There were no differences in sleep duration in either group. During the 1-h, constraint-free sleep recording, sleep rebound was observed in the noise-only group but not in the RF-EMF-only and RF-EMF + noise groups. CONCLUSION: Our study showed effects of RF-EMF, regardless of whether or not the animals were also exposed to noise. However, the RF-EMF + noise group presented no exacerbation of those effects. Our results did not support the hypothesis whereby the effects of RF-EMF on physiological functions studied are only visible in animals exposed to both noise and RF-EMF.

Impacts of Subchronic, High-Level Noise Exposure on Sleep and Metabolic Parameters: A Juvenile Rodent Model.

BACKGROUND: Noise is an environmental factor that has been associated with metabolic and sleep disorders. Sleep is a vital function, since it underpins physiologic processes and cognitive recovery and development. However, the effects of chronic noise exposure on the developing organism are still subject to debate. OBJECTIVE: The objective of the present study was to assess the effects of subchronic, high-level noise exposure on sleep, apnea, and homeostasis in juvenile rats. METHODS: Twenty-four 3-wk-old male Wistar rats were exposed to noise [[Formula: see text], [Formula: see text]] for 5 wk and 2 d during the 12-h rest period. Data on sleep stages, food and water intake, apnea, and body and organ weight were recorded. RESULTS: Five weeks of high-level noise exposure were associated with hyperphagia ([Formula: see text]), body weight gain ([Formula: see text]), a heavier thymus ([Formula: see text]), and heavier adrenal glands ([Formula: see text]). A sleep analysis highlighted microstructural differences in the active period: in particular, the mean daily amount of rapid eye movement (REM) sleep as a proportion of total sleep time (TST) was higher. The mean daily amount of non-REM (NREM) sleep was lower in the exposed group, meaning that the intergroup difference in the TST was not significant. During a 1-h, noise-free plethysmographic recording during the rest period, the mean total amount of active wakefulness (AW) was lower in the exposed group (by 9.1 min), whereas the mean duration of an episode of REM sleep was higher (by 1.8 min), and the TST was higher (by 10.7 min). DISCUSSION: Subchronic exposure of juvenile rats to high-intensity noise during the rest period was associated with some small but significant sleep disturbances, greater food and water intakes, greater body weight gain, and greater thymus and adrenal gland weights. The main effects of noise exposure on sleep were also observed in the 1-h plethysmography session after 5 wk of exposure. https://doi.org/10.1289/EHP4045.

Distal skin vasodilation in sleep preparedness, and its impact on thermal status in preterm neonates.

OBJECTIVE: Prior to sleep onset in human adults, distal body temperatures change progressively from wakefulness levels (low skin temperatures and a high core temperature) to sleep levels (high skin temperatures and a low core temperature) due to distal skin vasodilation and greater body cooling. It is not known whether this sleep preparedness exists in preterm neonates, even though sleep has a key role in neonatal health and neurodevelopment. The present study's objectives were to determine whether sleep preparedness (as observed in adults) can be evidenced in preterm neonates, and to assess repercussions on thermal stress. METHODS: During a 12-h night-time polysomnography session, skin temperatures (recorded with an infrared camera), sleep, and wakefulness episodes were measured in 18 nine-day-old preterm neonates. RESULTS: Fifteen wakefulness episodes were considered. Our results highlighted significant pre-sleep distal skin vasodilation (mainly at the foot: an increase of 0.38 °C in the 20 min preceding sleep onset) for the first time in preterm neonates. This vasodilation occurred even though (1) most factors known to influence pre-sleep vasodilation in adults were not present in these neonates, and (2) the neonates were nursed in a nearly constant thermal environment. The vasodilatation-related increase in body heat loss corresponded to a 0.15°C/h fall in mean body temperature (calculated using partitional calorimetry). CONCLUSION: Compensation for this body heat loss and the maintenance of body homeothermia would require a 4% increase in metabolic heat production. In neonates, this type of energy expenditure cannot be maintained for a long period of time.

Warming the premature infant in the delivery room: Quantification of the risk of hyperthermia.

AIM: The efficacy and safety of three polyethylene bags commonly used to prevent hypothermia in premature infants was assessed. METHODS: To simulate transfer from the delivery room to a secondary care unit, a thermally stable, bonneted mannequin (skin temperature: 34.4 °C) was placed in a climate chamber under different conditions: with a radiant warmer, with various polyethylene bags (open on one side, closed by a draw-string at the neck, or a "life support pouch" with several access points) or without a bag. RESULTS: With the radiant warmer turned on, the mean reduction in heat loss from the nude mannequin was 50.8 ±â€¯1.7% (p < 0.0001, vs. warmer off). The mean reduction in heat loss (vs. no bag) was 55.0 ±â€¯0.9% for the drawstring bag, 49.0 ±â€¯2.2% for the standard bag (p = 0.0001), and 48.1 ±â€¯0.7% for the life support pouch (p = 0.006). When a radiant warmer + polyethylene bag were used, heat stress (body temperature: 38 °C) and severe hyperthermia (40 °C) occurred after 11 and 34 min, respectively. CONCLUSION: Caution must be taken when using a radiant warmer and polyethylene bag with a premature infant. Heat stress can occur in only 11 min. Continuous body temperature monitoring is therefore required.

Effects of Smoking Exposure in Infants on Gastroesophageal Reflux as a Function of the Sleep-Wakefulness State.

OBJECTIVE: To determine whether perinatal smoking exposure is associated with gastroesophageal reflux (GER)-related changes in sleep-wakefulness states in neonates. STUDY DESIGN: Thirty-one neonates, referred for the investigation of suspected GER, were recruited and underwent multichannel impedance-pH monitoring and synchronized 8- to 12-hour polysomnography. The infants' exposure to tobacco smoke was estimated by means of a urine cotinine assay. The total number, frequency (h-1), and mean duration (minutes) of GER-pH (reflux events detected by the pH electrode only) and GER-imp (reflux events with bolus movement detected by impedance) events were determined. Intergroup differences (smoking-exposed group vs nonexposed group) were probed with nonparametric, unpaired Mann-Whitney U tests. A χ2 test was used to assess a possible intergroup difference in bolus retrograde migration during GER-imp events. RESULTS: According to the urine cotinine assay, 21 of the 31 neonates had been exposed to cigarette smoke during the perinatal period. The number (and frequency) of GER-imp was significantly greater (P = .016) in the exposed group (29 [0-90]) than in the nonexposed group (12 [2-35]). Migration of the esophageal bolus from the distal segment to the most proximal segment was significantly more frequent (P = .016) in the exposed group (83% of GER) than in the nonexposed group (41%). The GER pattern associated with smoking exposure was particularly obvious during Rapid eye movement sleep. CONCLUSIONS: The more frequent occurrence and greater proximal migration of GER-imp in the smoking-exposed group (especially during rapid eye movement sleep) may have clinical relevance. Smoking exposure is a preventable risk factor for limiting the occurrence of GER in neonates.

Use of a combination of in vitro models to investigate the impact of chlorpyrifos and inulin on the intestinal microbiota and the permeability of the intestinal mucosa.

Dietary exposure to the organophosphorothionate pesticide chlorpyrifos (CPF) has been linked to dysbiosis of the gut microbiota. We therefore sought to investigate whether (i) CPF's impact extends to the intestinal barrier and (ii) the prebiotic inulin could prevent such an effect. In vitro models mimicking the intestinal environment (the SHIME®) and the intestinal mucosa (Caco-2/TC7 cells) were exposed to CPF. After the SHIME® had been exposed to CPF and/or inulin, we assessed the system's bacterial and metabolic profiles. Extracts from the SHIME®'s colon reactors were then transferred to Caco-2/TC7 cultures, and epithelial barrier integrity and function were assessed. We found that inulin co-treatment partially reversed CPF-induced dysbiosis and increased short-chain fatty acid production in the SHIME®. Furthermore, co-treatment impacted tight junction gene expression and inhibited pro-inflammatory signaling in the Caco-2/TC7 intestinal cell line. Whereas, an isolated in vitro assessment of CPF and inulin effects provides useful information on the mechanism of dysbiosis, combining two in vitro models increases the in vivo relevance.

Impact of chronic exposure to the pesticide chlorpyrifos on respiratory parameters and sleep apnea in juvenile and adult rats.

The widely used organophosphorus pesticide chlorpyrifos (CPF) is often detected in food. CPF inhibits acetylcholinesterase and can modify muscle contractility and respiratory patterns. We studied the effects of chronic exposure to CPF on respiratory parameters and diaphragm contractility in 21- and 60-days old rats. Pregnant rats were exposed to oral CPF (1 or 5 mg/ kg /day: CPF-1 or CPF-5 groups vs vehicle: controls) from gestation onset up to weaning of the pups that were individually gavaged (CPF or vehicle) thereafter. Two developmental time points were studied: weaning (day 21) and adulthood (day 60). Whole-body plethysmography was used to score breathing patterns and apnea index during sleep. Then, diaphragm strips were dissected for the assessment of contractility and acetylcholinesterase activity. Results showed that the sleep apnea index was higher in CPF-exposed rats than in controls. In adult rats, the expiratory time and tidal volume were higher in CPF-exposed animals than in controls. At both ages, the diaphragm's amplitude of contraction and fatigability index were higher in the CPF-5 group, due to lower acetylcholinesterase activity. We conclude that chronic exposure to CPF is associated with higher sleep apnea index and diaphragm contractility, and modifies respiratory patterns in sleeping juvenile and adult rats.

The hypoxic test in preterm neonates reinvestigated.

AIM: We currently lack a suitable gold-standard method for implementation on modern equipment to assess peripheral chemoreceptor sensitivity. The aim of the present study was to develop an accurate and reproducible method for assessing peripheral chemoreceptors sensitivity in sleeping preterm neonates. METHODS: A poïkilocapnic hypoxic test was performed twice during rapid eye movement sleep (REM sleep) and non-rapid eye movement sleep (nonREM sleep). The infant breathed hypoxic gas (15% O2 ) for 60 s. The ventilatory response to hypoxia was assessed by comparing minute ventilation during the control period (21% O2 ) with successive 4-cycles sequences during hypoxia. We detected the first statistically significant increase in minute ventilation and recorded the corresponding response time. RESULTS: During normoxia, minute ventilation was higher during REM sleep than in nonREM sleep (428.1 mL · min-1 · kg-1 [307.7-633.6]; 388.8 mL · min-1 · kg-1 [264.7-608.0], respectively; P = 0.001). After hypoxia, minute ventilation increased in both REM and nonREM sleep. The response was significantly higher in REM than in nonREM (25.3% [10.8-80.0] and 16.8% [7.5-33.2], respectively; P = 0.005). The intraclass correlation coefficients for all respiratory parameters were above 0.90. CONCLUSION: We have developed a highly reliable method for assessing peripheral chemoreceptors sensitivity at the response time to hypoxia. In the future, researchers could use this method to assess the involvement of peripheral chemoreceptors in infants who experience chronic hypoxia (e.g. in bronchopulmonary dysplasia and recurrent apnea).

Thermal management in closed incubators: New software for assessing the impact of humidity on the optimal incubator air temperature.

BACKGROUND: Low-birth-weight (LBW) neonates are nursed in closed incubators to prevent transcutaneous water loss. The RH's impact on the optimal incubator air temperature setting has not been studied. METHODS: On the basis of a clinical cohort study, we modelled all the ambient parameters influencing body heat losses and gains. The algorithm quantifies the change in RH on the air temperature, to maintain optimal thermal conditions in the incubator. RESULTS: Twenty-three neonates (gestational age (GA): 30.0 [28.9-31.6] weeks) were included. A 20% increase and a 20% decrease in the RH induced a change in air temperature of between -1.51 and +1.85°C for a simulated 650g neonate (GA: 26 weeks), between -1.66 and +1.87°C for a 1000g neonate (GA: 31 weeks), and between -1.77 and +1.97°C for a 2000g neonate (GA: 33 weeks) (p<0.001). According to regression analyses, the optimal incubator air temperature=a+b relative humidity +c age +d weight (p<0.001). CONCLUSIONS: We have developed new mathematical equations for calculating the optimal temperature for the incubator air as a function of the latter's relative humidity. The software constitutes a decision support tool for improving patient care in routine clinical practice.