Apnea of Prematurity in Neonates:
What is Apnea?
It is defined as the cessation of respiration for > 20 seconds or cessation of respiration for any duration accompanied by decrease in heart rate (<100 beats/minute) and /or cyanosis.
What is Apnea of Prematurity?
About 30-40% of preterm babies (less than 36 weeks of gestation) exhibit a period breathing pattern in which there are pauses. It is commonly found in premature babies and if untreated can result in severe oxygen crises to the brain and even death.
What are the causes of Apnea of Prematurity?
The most common cause is the immaturity of the central nervous system. In prematurely delivered babies, the nervous system is not well developed. The respiratory center in the brain does not provide enough stimuli for the breathing to take place and results in the cessation of breathing for a certain period of time. There are a number of other factors also contributed to apnea of prematurity for example
- Increased environmental temperature
- Decreased environmental temperature
- Birth traumas resulting in some neurological defects
- Use of certain drugs, for example narcotics during pregnancy
- Respiratory distress syndrome
- Cardiac abnormalities
- Infections
- Increased blood sugar
- Decreased blood sugar levels
What Should Be Done?
If the newborn is exhibiting the features of apnea of prematurity, the emergency medical care should be sought immediately. The medical care includes;
Evaluation of the reasons of apnea of prematurity
o This involves some laboratory investigations including X-rays
o Clinical examination of the baby
o History from the parents
Treatment includes
o Taking care of the underlying cause of apnea
o Providing support to the baby via oxygen. If necessary, the baby may require mechanical ventilation support from machines for certain period of time.
o Use of some drugs, for example bronchodilators (Salbutamole, Ipratropium etc), respiratory stimulants (Caffeine, Aminophyllin etc).
o Use of antibiotics if an infections is suspected
n Establishing the oral feeding when sufficiently improved in the clinical status
Further Readings and Reference: http://emedicine.medscape.com/article/974971-overview
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Unknown - Thursday, 31 March 2011
