Apnoea of Prematurity

Last updated 20.09.12

 

Index

 

Definition

-  Nil effective resp effort for 20sec or less if ass w bradycardia (<100), cyanosis or pallor

-  Central: complete cessation of chest movement

-  Obstructive: pause secondary to obstruction, with attempted resp efforts

-  Mixed

 

Features

-  Dx of exclusion in <34 weeks premature infants

-  Not a risk factor for SIDS

-  Apnoea on day 1 is NOT normal

-  Incidence

-  <30 weeks most infants

-  30-32 weeks 50%

-  32-34 weeks 10%

-  Usually resolves by 36 weeks CA

-  Central

-  10-15% all apnoeas

-  May be provoked by vagal stimulation (oral or nasal suction, NGT)

-  Obstructive

-  10-15% all apnoeas

-  Mixed

-  50-75% all apnoeas

 

DDx

-  Periodic breathing: resp pauses >3 sec + <20 sec respiration between pauses

 

Causes of Apnoea in Infants

-  Day 1-2: sepsis, hypoglycaemia, impending resp failure, polycythemia

-  Day 3-6: sepsis, impending resp failure, PDA, massive IVH, apnoea of prematurity

 

Ix

-  O2Sats

-  BSL

-  CRP, FBE

-  +/- BC

 

Mx

-  Cardiorespiratory monitor

-  Apnoea monitor

-  Mx of apnoea

-  Caffeine IV

-  Loading dose 20mg/kg Daily --> maintenance 5mg/kg Daily

-  Ceased once apnoea fee for 1-2 weeks+ & >34 weeks CA

-  Monitor for 1/52 post ceases

 

 

 

References