Apnea (newborn): Difference between revisions
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'''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">{{ | '''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">{{Cite|type = book|surname1= Muntau|Name1= Ania Carolina|kolektiv = ne|title= Pediatrie|edition= 4|Place= Praha|Publisher= Grada|year= 2009|page= 14|isbn = 978-80-247-2525-3}}</ref> | ||
== Types of apnea according to etiopathogenesis == | == Types of apnea according to etiopathogenesis == | ||
Revision as of 12:00, 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 MUNTAU,. Pediatrie. 4. edition. 2009. ISBN 978-80-247-2525-3.
- ↑ Jump up to: a b c HAVRÁNEK, Jiří: Respirace.
Kategorie:Pediatrie
Kategorie:Neonatologie
Kategorie:Pneumologie
Kategorie:Vnitřní lékařství
Kategorie:Interní propedeutika
