Abstract：
BACKGROUND: Periodic breathing (PB)-related intermittent hypoxia can have long-lasting deleterious consequences in preterm infants. Olfactory stimulation using vanilla odor is beneficial for apnea of prematurity in the first postnatal days/weeks. We aimed to determine for the first time whether vanilla odor can also decrease PB-related intermittent hypoxia.
METHODS: This pilot study was a balanced crossover clinical trial including 27 premature infants born between 30 and 33+6 weeks of gestation. We performed 12-h recordings on two nights separated by a 24-h period. All infants were randomly exposed to vanilla odor on the first or second study night. The primary outcome was the desaturation index, defined as the number per hour of pulse oximetry (SpO2) values <90 % for at least 5 s, together with a drop of ≥5 % from the preceding value. Univariate mixed linear models were used for the statistical analysis.
RESULTS: Overall, exposure to vanilla odor did not significantly decrease the desaturation index (52 ± 22 events/h [mean ± SD] on the intervention night vs. 57 ± 26, p = 0.2); furthermore, it did not significantly alter any secondary outcome. In a preliminary post hoc subgroup analysis, however, the effect of vanilla odor was statistically significant in infants with a desaturation index of ≥70/h (from 86 ± 12 to 65 ± 23, p = 0.04).
CONCLUSIONS: In this pilot study, vanilla odor overall did not decrease PB-related intermittent hypoxia in infants born at 30-33+6 weeks of gestation, which is when they are close to term. Preliminary results suggesting a beneficial effect in infants with the highest desaturation index, however, justify further studies in the presence of PB-related intermittent hypoxia as well as in infants born more prematurely.
METHODS: This pilot study was a balanced crossover clinical trial including 27 premature infants born between 30 and 33+6 weeks of gestation. We performed 12-h recordings on two nights separated by a 24-h period. All infants were randomly exposed to vanilla odor on the first or second study night. The primary outcome was the desaturation index, defined as the number per hour of pulse oximetry (SpO2) values <90 % for at least 5 s, together with a drop of ≥5 % from the preceding value. Univariate mixed linear models were used for the statistical analysis.
RESULTS: Overall, exposure to vanilla odor did not significantly decrease the desaturation index (52 ± 22 events/h [mean ± SD] on the intervention night vs. 57 ± 26, p = 0.2); furthermore, it did not significantly alter any secondary outcome. In a preliminary post hoc subgroup analysis, however, the effect of vanilla odor was statistically significant in infants with a desaturation index of ≥70/h (from 86 ± 12 to 65 ± 23, p = 0.04).
CONCLUSIONS: In this pilot study, vanilla odor overall did not decrease PB-related intermittent hypoxia in infants born at 30-33+6 weeks of gestation, which is when they are close to term. Preliminary results suggesting a beneficial effect in infants with the highest desaturation index, however, justify further studies in the presence of PB-related intermittent hypoxia as well as in infants born more prematurely.
摘要：
背景：与周期性呼吸（PB）相关的间歇性缺氧会对早产儿产生长期的有害后果。使用香草气味的嗅觉刺激对于出生后第一天/周的早产儿呼吸暂停是有益的。我们旨在首次确定香草味是否也可以减少与PB相关的间歇性缺氧。
方法：这项初步研究是一项平衡交叉临床试验，包括27名出生在妊娠30至33+6周之间的早产儿。我们在24小时间隔的两个晚上进行了12小时的录音。所有婴儿在第一个或第二个研究之夜随机暴露于香草味。主要结果是去饱和指数，定义为每小时脉搏血氧饱和度（SpO2）值<90％，持续至少5s，与先前值相比下降≥5%。单变量混合线性模型用于统计分析。
结果：总体而言，暴露于香草味并没有显着降低去饱和指数（干预之夜的52±22事件/h[平均值±SD]与57±26，p=0.2)；此外，它没有显著改变任何次要结局.在初步的事后分组分析中，然而,在去饱和指数≥70/h的婴儿中，香草味的影响具有统计学意义（从86±12到65±23，p=0.04）。
结论：在这项初步研究中，香草味总体上并没有减少妊娠30-33+6周出生的婴儿与PB相关的间歇性缺氧，也就是他们接近任期的时候。初步结果表明，对去饱和指数最高的婴儿有有益的作用，然而,证明在存在与PB相关的间歇性缺氧以及早产婴儿的情况下进行进一步研究。
方法：这项初步研究是一项平衡交叉临床试验，包括27名出生在妊娠30至33+6周之间的早产儿。我们在24小时间隔的两个晚上进行了12小时的录音。所有婴儿在第一个或第二个研究之夜随机暴露于香草味。主要结果是去饱和指数，定义为每小时脉搏血氧饱和度（SpO2）值<90％，持续至少5s，与先前值相比下降≥5%。单变量混合线性模型用于统计分析。
结果：总体而言，暴露于香草味并没有显着降低去饱和指数（干预之夜的52±22事件/h[平均值±SD]与57±26，p=0.2)；此外，它没有显著改变任何次要结局.在初步的事后分组分析中，然而,在去饱和指数≥70/h的婴儿中，香草味的影响具有统计学意义（从86±12到65±23，p=0.04）。
结论：在这项初步研究中，香草味总体上并没有减少妊娠30-33+6周出生的婴儿与PB相关的间歇性缺氧，也就是他们接近任期的时候。初步结果表明，对去饱和指数最高的婴儿有有益的作用，然而,证明在存在与PB相关的间歇性缺氧以及早产婴儿的情况下进行进一步研究。
