{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T19:46:00Z","timestamp":1757706360767},"reference-count":38,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2002,1,12]],"date-time":"2002-01-12T00:00:00Z","timestamp":1010793600000},"content-version":"vor","delay-in-days":175,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clin Exp Pharma Physio"],"published-print":{"date-parts":[[2001,7,21]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>1. In infants, promethazine has been implicated in the pathogenesis of sleep apnoea, apparent life threatening events (ALTE) and the Sudden Infant Death syndrome (SIDS). The aim of the present study was to investigate, in a neonatal animal, the effects of a commonly used promethazine\u2010containing medication on airway protective mechanisms and cardiorespiratory reflexes following simulated gastro\u2010oesophageal reflux (GER) to different levels in the oesophagus and pharynx.<\/jats:p><jats:p>2. Physiological and radiographic recordings were made in 21 naturally sleeping (controls) and 21 sedated (1.5 mg\/kg, p.o., promethazine) piglets. On 3 consecutive days physiological recordings were made in all piglets during active sleep. Gastro\u2010oesophageal reflux was simulated by the injection of boluses of 0.5 mL HCl, pH 2 or 3, or NaCl (0.9%) at 37\u00b0C into the pharynx, upper or lower oesophagus.<\/jats:p><jats:p>3. In healthy neonatal piglets, minimal sedation with promethazine, which did not affect behaviour during wakefulness, revealed previously unreported findings during active sleep.<\/jats:p><jats:p>4. The most significant effects were observed following simulated GER to the pharynx, with no effect observed in the lower oesophagus. In sedated piglets, compared with naturally sleeping piglets, there was a significant reduction in swallowing (<jats:italic>P<\/jats:italic> &lt; 0.01), delayed radiological clearance of fluid (<jats:italic>P<\/jats:italic> &lt; 0.05), a reduction in breathing rate, oxygen saturation and heart rate and an increase in apnoea.<\/jats:p><jats:p>5. These findings are consistent with a low dose of promethazine producing a significant attenuation of airway protective mechanisms and, thus, stimulation of the laryngeal chemoreflex. The results suggest a mechanism for the association observed between promethazine use and the occurrence of ALTE and SIDS. The results support continued caution and suggest the need for greater regulation of promethazine\u2010containing medications in infants.<\/jats:p>","DOI":"10.1046\/j.1440-1681.2001.03483.x","type":"journal-article","created":{"date-parts":[[2003,3,11]],"date-time":"2003-03-11T11:10:27Z","timestamp":1047381027000},"page":"533-539","source":"Crossref","is-referenced-by-count":16,"title":["Airway Protection Following Simulated Gastro\u2010Oesophageal Reflux In Sedated And Sleeping Neonatal Piglets During Active Sleep"],"prefix":"10.1111","volume":"28","author":[{"given":"George M","family":"McKelvey","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elizabeth J","family":"Post","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew Kw","family":"Wood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather E","family":"Jeffery","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2002,1,12]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3468(91)90012-I"},{"key":"e_1_2_6_3_2","doi-asserted-by":"crossref","first-page":"924","DOI":"10.1542\/peds.60.6.924","article-title":"Respiratory arrest in infants secondary to gastroesophageal reflux.","volume":"60","author":"Leape L","year":"1977","journal-title":"Pediatrics"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01954386"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3476(85)80091-3"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0379-0738(88)90152-1"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1681.1995.tb02064.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.104.2.263"},{"key":"e_1_2_6_9_2","doi-asserted-by":"crossref","unstructured":"PageM&JefferyHE.The role of gastro\u2010oesophageal reflux in the aetiology of SIDS.Early Hum. 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