Apnea (newborn)
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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]
- Obstructive
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.
- Mixed
They usually start as peripheral with a subsequent central respiratory disorder. They are most often associated with accompanying bradycardia.
- Reflective
Cause: GER – the intermediary here is the vagus nerve.
- Idiopathic
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.
- Symptomatic
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:
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- thermoneutral environment (cave! hypothermia),
- correct head position (cave! anteflexion),
- orogastric tube preferred over nasogastric tube,
- tactile stimulation,
- casual treatment of the cause[2].
