Apnea of prematurity is defined as cessation of breathing by a premature infant that lasts for more than 20 seconds and/or is accompanied by hypoxia or bradycardia. Apnea is traditionally classified as either obstructive, central, or mixed. Obstructive apnea may occur when the infant's neck is hyperflexed or conversely, hyperextended. It may also occur due to low pharyngeal muscle tone or to inflammation of the soft tissues, which can block the flow of air though the pharynx and vocal cords. Central apnea occurs when there is a lack of respiratory effort. This may result from central nervous system immaturity, or from the effects of medications or illness. Many episodes of apnea of prematurity may start as either obstructive or central, but then involve elements of both, becoming mixed in nature.
1 Pathophysiology 2 Diagnosis 3 Treatment
3.1 Medications 3.2 Respiratory support 3.3 Monitoring
4 Outcome 5 Epidemiology 6 References 7 External links
Ventilatory drive is primarily dependent on response to increased
levels of carbon dioxide (CO2) and acid in the blood. A secondary
stimulus is hypoxia. Responses to these stimuli are impaired in
premature infants due to immaturity of specialized regions of the
brain that sense these changes. In addition, premature infants have an
exaggerated response to laryngeal stimulation (a normal reflex that
closes the airway as a protective measure).
Apnea of prematurity can be readily identified from other forms of
infant apnea such as obstructive apnea, hypoventilation syndromes,
breathing regulation issues during feeding, and reflux associated
apnea with an infant pneumogram or infant apnea/sleep study.
^ a b Martin R.J.; et al. (2002). "Pathophysiologic Mechanisms Underlying Apnea of Prematurity". NeoReviews. 3 (4): e59–e65. doi:10.1542/neo.3-4-e59. ^ Baird, T.M.; et al. (2002). "Clinical Associations, Treatment, and Outcome of Apnea of Prematurity". NeoReviews. 3 (4): e66–e70. doi:10.1542/neo.3-4-e66. ^ Atik, Anzari; Harding, Richard; De Matteo, Robert; Kondos-Devcic, Delphi; Cheong, Jeanie; Doyle, Lex W.; Tolcos, Mary (January 2017). "Caffeine for apnea of prematurity: Effects on the developing brain". NeuroToxicology. 58: 94–102. doi:10.1016/j.neuro.2016.11.012.
Information about apnea of prematurity - The Hospital for Sick Children Information about Infant Apnea or near-miss SIDS testing - Apnea Research
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Symptoms and signs relating to the respiratory system (R04–R07, 786)
Medical examination and history taking
Stethoscope Respiratory sounds
Stridor Wheeze Crackles Rhonchi Stertor Squawk Pleural friction rub Fremitus Bronchophony Terminal secretions
Percussion Pectoriloquy Whispered pectoriloquy Egophony
Dyspnea Hyperventilation Hypoventilation Hyperpnea Tachypnea Hypopnea Bradypnea
Agonal respiration Biot's respiration Cheyne–Stokes respiration Kussmaul breathing Ataxic respiration
Respiratory distress Respiratory arrest Orthopnea/Platypnea Trepopnea Aerophagia Asphyxia Breath holding Mouth breathing Snoring
In children Precordial catch syndrome Pleurisy
Nail clubbing Cyanosis Cough Sputum Hemoptysis Epistaxis Silhouette sign Post-nasal drip Hiccup COPD
Curschmann's spirals Charcot–Leyden crystals
Hampton hump Westermark sign