Apnea (newborn): Difference between revisions
(original text from wikiskripta https://www-wikiskripta-eu.translate.goog/index.php?title=Apnoe_(novorozenec)&action=edit&_x_tr_sl=auto&_x_tr_tl=en&_x_tr_hl=iw&_x_tr_pto=wapp) |
(translated) |
||
| Line 1: | Line 1: | ||
__TOC__ | __TOC__ | ||
''' | '''Apnea''', or apneic pause, is the absence of breath lasting longer than '''20 seconds''' with a decreased in '''O<sub>2</sub>''' '''saturation''' ([[cyanóza|cyanosis]]) or even '''[[Bradykardie|bradycardia]]''' (heart rate < 100/min.).hey often appear in premature babies as so-called ''idiopathic apnea'' caused by the immaturity [[dechová centra|respiratory center]].<ref name="muntau">{{Citace |typ = kniha|příjmení1 = Muntau|jméno1 = Ania Carolina|kolektiv = ne|titul = Pediatrie|vydání = 4|místo = Praha|vydavatel = Grada|rok = 2009|strany = 14|isbn = 978-80-247-2525-3}}</ref> | ||
== | == Types of apnea according to etiopathogenesis == | ||
; | ;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 [[Vrozené vývojové vady dýchací soustavy|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, [[vrozené srdeční vady|congenital heart defects]], CNS insults– [[vrozené vývojové vady|congenital developmental defects]], trauma, [[krvácení|bleeding]], [[zánět|inflammation]], convulsions, hypothermia/hyperthermia, [[šok|shock]], [[asfyxie|asphyxia]], [[anémie|anemia]]. Metabolic causes- [[acidóza|acidosis]], [[hypoglykemie|hypoglycemia]], [[hypokalcemie|hypocalcemia]], hyponatremia, DPM. | |||
; | ;Mixed | ||
They usually start as peripheral with a subsequent central respiratory disorder. They are most often associated with accompanying [[Bradykardie|bradycardia]]. | |||
; | ;Reflective | ||
Cause: [[Gastroezofageální reflux (pediatrie)|GER]] – the intermediary here is the [[Nervus vagus|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 [[Hypoxie|hypoxia]] with an apneic pause instead of [[hyperventilace|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, [[Syndrom dechové tísně (pediatrie)|Respiratory distress syndrome (pediatrics)]], sepsis, aspiration, maternal drug abuse, airway obstruction, [[pneumonie|pneumonia]], [[meningitida|meningitis]]…<ref name="Havranek">HAVRÁNEK, Jiří: ''Respirace''.</ref><ref name="muntau" /> | |||
== | == Clinical picture == | ||
* | Apnoeic pause, [[cyanóza|cyanosis]], hypotonia, [[bradykardie|bradycardia]]. | ||
** | |||
** | == Diagnosis == | ||
** | „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<ref name="Havranek" />). | ||
* | |||
* | == Therapy == | ||
{{Pahýl}} | * General precautions: | ||
* | |||
** thermoneutral environment (cave! hypothermia), | |||
** correct head position (cave! anteflexion), | |||
** orogastric tube preferred over nasogastric tube, | |||
* tactile stimulation, | |||
* casual treatment of the cause<ref name="Havranek" />. | |||
{{Pahýl}} | |||
<noinclude> | <noinclude> | ||
== | == Links == | ||
=== | === Related Articles === | ||
* [[Dyspnoe]] | * [[Dyspnoe|Dyspnea]] | ||
=== | === References === | ||
<references/> | <references/> | ||
</noinclude> | </noinclude> | ||
Revision as of 11:50, 15 February 2023
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
- 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
Apnoeic pause, cyanosis, hypotonia, bradycardia.
Diagnosis
„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
- 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
Related Articles
References
- ↑ Jump up to: a b
- ↑ Jump up to: a b c HAVRÁNEK, Jiří: Respirace.
Kategorie:Pediatrie
Kategorie:Neonatologie
Kategorie:Pneumologie
Kategorie:Vnitřní lékařství
Kategorie:Interní propedeutika
