Apnea of prematurity
Cessation of Respiration for 20 second with or without bradycardia and cyanosis.
Common Problem in preterm Neonates, occurs between 2nd-5th days.
Due to immaturity of developing brain.
Types of Apnea
1. According to etiology
a. Central apnea
Due to pathological cause, sepsis, Metabolic problem, hypoglycemia, hypocalcemia, temperature instability, Respiratory disease.
b. Obstructive apnea
The blockage of airway secretion.
c. Mixed type
Central obstruction and improper positioning
2. According to classification (central obstruction)
a. Primary Apnea
Shortness of breath.
Infant deprived of oxygen, initially brief period of rapid breathing.
Asphyxia continues;
Respiratory movement ceases
Heart rate begins to fail
Neuromuscular tone gradually diminished
Infant enters a period of Apnea
b. Secondary Apnea
If after primary Apnea, asphyxia continues, infant develop deep gasping respiration.
Heart rate continues to fall
Blood pressure fall
Infant becomes nearly flaccid (hanging loosely)
Respiration become weaker and weaker
Pathophysiology
Increase level of CO2 and lactic acid in blood
Hypoxia
Impaired in premature infants due to under development of respiratory center of brain.
Leading Apnea
Management
1. Aminophylline
2. Theophylline
3. Caffeine
4. Doxapram
Used to treat Apnea of prematurity
2. Monitoring
3. Respiratory support
Oxygen blood
CPAP (continuous positive airway pressure)
Tactile stimulation (rising infant level of alertness)
Prognosis
When Respiration center of brain matures.
Apnea of prematurity disappears after 42 weeks of age.
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