Apnea in the Newborn

[Pages:14]Apnea in the Newborn

Rajiv Aggarwal, Ashwini Singhal, Ashok K Deorari, Vinod K Paul Division of Neonatology, Department of Pediatrics All India Institute of Medical Sciences Ansari Nagar, New Delhi ?110029

Address for correspondence: Dr Vinod K Paul Additional Professor Department of Pediatrics All India Institute of Medical Sciences Ansari Nagar, New Delhi 110029 Email: vinodkpaul@

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Abstract

Apnea, defined as cessation of breathing resulting in pathological changes in heart rate and oxygen saturation, is a common occurrence in sick neonates. Apnea is a common manifestation of various etiologies in sick neonates. In preterm children it may be related to the immaturity of the central nervous system. Secondary causes of apnea should be excluded before a diagnosis of apnea of prematurity is made. Methylxanthines and Continuous Positive Airway Pressure form the mainstay of treatment of apnea in neonates. Mechanical ventilation is reserved for apnea resistant to above therapy. An approach to the management of apnea in neonates has been described.

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Apnea in the Newborn

1. Introduction About 30-45% of preterm babies exhibit a periodic breathing pattern characterized by 3 or more respiratory pauses of greater than 3 seconds duration with less than 20 seconds respiration between pauses. Periodic breathing is a normal event, is usually not associated with any physiological changes in the infant and does not merit any treatment. Apnea is a pathological cessation of breathing that results in physiological changes (decrease in central drive, peripheral perfusion, cyanosis, bradycardia, hypotonia) and merits treatment.

2. Definition Apnea is defined as cessation of respiration for >20 sec or cessation of respiration of any duration accompanied by bradycardia (HR ................
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