Apnea (newborn)

From WikiLectures

Signature.png   This article is a stub.
You can join the authors and edit it. You can discuss the changes at discussion.

Apnea, or apneic pause, is the absence of breath lasting longer than 20 seconds with a decreased in O2 saturation (cyanosis) or even bradycardia (heart rate < 100/min.).hey often appear in premature babies as so-called idiopathic apnea caused by the immaturity respiratory center.[1]

Types of apnea according to etiopathogenesis[edit | edit source]


Airflow is absent, but respiratory movements are preserved. They are most often of pharyngeal origin, the provoking factors include, among others. pronation position = prone position and head flexion. Other causes: obstruction of airways stenosis, atresia compression of airways.

Central (most common)

There is a lack of air flow and breathing movements. Causes: immaturity, maternal or child medication, sepsis, congenital heart defects, CNS insults– congenital developmental defects, trauma, bleeding, inflammation, convulsions, hypothermia/hyperthermia, shock, asphyxia, anemia. Metabolic causes- acidosis, hypoglycemia, hypocalcemia, hyponatremia, DPM.


They usually start as peripheral with a subsequent central respiratory disorder. They are most often associated with accompanying bradycardia.


Cause: GER – the intermediary here is the vagus nerve.


nterruption of breathing for more than 15-20 s without a clear pathological cause. In premature infants who do not have fully developed axodendritic connections of respiratory neurons in the brainstem – they respond to hypoxia with an apneic pause instead of hyperventilation. Common in children with a birth weight of less than 1000 g, the incidence subsides after 36 weeks of postconceptional age.

Note: any apnea in a term newborn should be considered pathological.

Caused by intracranial hemorrhage, Respiratory distress syndrome (pediatrics), sepsis, aspiration, maternal drug abuse, airway obstruction, pneumonia, meningitis[2][1]

Clinical picture[edit | edit source]

Apnoeic pause, cyanosis, hypotonia, bradycardia.

Diagnosis[edit | edit source]

„Baby sense monitor“, monitoring of vital functions, pulse oximetry, (pauses lasting < 10 seconds, which often accompany feeding, defecation or movements of the newborn, should be excluded[2]).

Therapy[edit | edit source]

  • General precautions:
    • thermoneutral environment (cave! hypothermia),
    • correct head position (cave! anteflexion),
    • orogastric tube preferred over nasogastric tube,
  • tactile stimulation,
  • casual treatment of the cause[2].

Links[edit | edit source]

Related Articles[edit | edit source]

References[edit | edit source]

  1. a b MUNTAU,. Pediatrie. 4. edition. 2009. ISBN 978-80-247-2525-3.
  2. a b c HAVRÁNEK, Jiří: Respirace.