What Is Administered To Infants Having Episodes Of Apnea?

Apnea of prematurity (AOP) is a developmental disorder in preterm infants caused by immature respiratory control. It is characterized by frequent, prolonged, or needing frequent apneic spells. Apneic spells are defined as cessations of breathing lasting more than 20 seconds or a shorter pause accompanied by bradycardia (<100 beats per minute). Apnea is more common in infants born before 37 weeks of gestation and can be caused by various physiological and pathophysiological processes.

To treat AOP, many babies with AOP receive oral or intravenous caffeine medicine to stimulate their breathing. Proper positioning and slower feeding can help stimulate their breathing. Doxapram, a respiratory stimulant, is sometimes administered to preterm infants with AOP at doses of about 1.5 mg/kg per hour. Treatment for central apnea involves respiratory stimulants and head positioning for obstructive apnea.

The first-line treatment for AOP remains methylxanthines, with approximately 75 of premature infants receiving this medication. Several medications can help reduce spells of apnea by stimulating the part of the baby’s brain that controls breathing. Aminophylline and theophylline are the most commonly used drugs, while caffeine may also be used.

In summary, apnea of prematurity is a developmental disorder in preterm infants caused by immature respiratory control. Interventions are recommended for frequent, prolonged, or needing frequent apneic spells. Caffeine may also be used to stimulate breathing in babies with AOP.

What is the treatment of an apneic?

Sleep apnea, a condition characterized by snoring during sleep, can be treated through various lifestyle changes, including breathing devices, oral devices, surgical implants, and therapy for the mouth and facial muscles. The most common treatment is a continuous positive airway pressure (CPAP) machine, which maintains constant air pressure in the upper airways to help breathe during sleep. However, CPAP treatment can cause side effects like congestion, dry eyes, dry mouth, nosebleeds, and runny nose.

What is used in the NICU to treat prevent apnea?

LISA is a noninvasive respiratory support used to help spontaneously breathe preterm infants, reducing the need for mechanical ventilation. It is typically administered with noninvasive forms of respiratory support like CPAP and NIPV. Apnea of prematurity is a physiological consequence of an immature respiratory system in premature babies, which can lead to hypercapnia and increased morbidity and mortality. There is no clear-cut “first-line” approach or gold standard of care for apnea of prematurity.

Effective treatments include caffeine citrate, carbon dioxide inhalation, nasal continuous positive airway pressure, and nasal intermittent positive pressure ventilation. More conservative treatments, such as kangaroo care, postural changes, and sensory stimulation, may not be effective. Apnea resolves spontaneously as the respiratory system matures, but it can complicate neonatal care and have both short-term and long-term consequences. The role of apnea of prematurity in mortality of preterm neonates is not clear.

How can I help my newborn with sleep apnea?

Apnea is a pause in breathing that lasts 20 seconds or longer for full-term infants, typically occurring after 39 weeks of pregnancy. It is caused by the brain’s inability to control breathing during sleep, leading to a slowing heart rate. Infants with apnea often experience long, unwarranted pauses in breathing, which can be triggered by various signs, such as snoring, snoring with a cannula, or using a ventilator. Most infants outgrow this issue by the age of one. Apnea is more common in premature babies born before 37 weeks.

What is apnea spells in newborns?

Apnea in infants refers to episodes of cessation of breathing, which can be caused by various physiological or pathophysiologic processes. Periodic breathing, which occurs in short cycles of 5 to 10 seconds, is not pathologic and is typically seen between two to four weeks and resolves by six months. Apnea is common in preterm infants but can occur at any age. Apnea of prematurity is sudden cessation lasting at least 20 seconds or accompanied by bradycardia or oxygen desaturation.

Apnea of infancy is unexplained cessation lasting 20 seconds or longer, or a shorter respiratory pause associated with bradycardia, cyanosis, pallor, and/or marked hypotonia. This activity discusses the differential diagnosis of infant apnea and the role of the interprofessional team in caring for these infants.

What is the drug of choice for apnea of prematurity?

Caffeine citrate is the preferred drug for treating apnea of prematurity, a respiratory disturbance of 15-20 seconds in prematurous infants. It is easy to use, can be administered orally or intravenously once a day, requires no serum concentration monitoring, and has few side effects. The article aims to review the mechanisms of action, effects, metabolism, pharmacokinetics, and adverse effects of caffeine citrate in prematurous infants, including its metabolism, pharmacodynamics, and pharmacokinetics.

What causes apneic spells in infants?

Preterm infants, particularly those under 28 weeks gestation, are highly susceptible to apnea due to their poor respiratory control mechanisms. Apnea after birth can occur due to birth asphyxia, maternal drug use, infections, metabolic causes, and congenital anomalies. Central apnea can be caused by central nervous system infections, head trauma, toxin exposure, pertussis, infant botulism, inborn metabolic errors, metabolic derangements, and congenital anomalies. Obstructive apnea can occur due to obstructive sleep apnea, infections, vocal cord paralysis, and congenital upper airway anomalies.

How do you treat apneic spells?

A protocol outlining escalating treatments for apnea of prematurity can be beneficial. Common treatments include stimulation, methylxanthine, or assisted ventilation like nasal continuous positive airway pressure (CPAP) or mechanical ventilation. Pantalitschka et al compared four modes of nasal respiratory support for apnea of prematurity in very low birthweight infants: intermittent positive pressure ventilation (IPPV), CPAP, and P2 and/or bag-mask ventilation.

They found that episodes of bradycardia or desaturation occurred at a rate of 6. 7 per hour with the conventional ventilator in IPPV mode and 2. 8 and 4. 4 per hour with the variable flow device in CPAP and IPPV mode, respectively. Avoiding hyperoxia can increase the risk of retinopathy of prematurity (ROP).

What agent is used to treat infant apnea?

Caffeine is a preferred drug for treating apnea of prematurity, facilitating successful extubation in preterm infants, and reducing the rate of bronchopulmonary dysplasia in very low-birth-weight infants. It has a wider therapeutic margin than other methylxanthines, making an overdose less likely. Caffeine has been proposed as an adjunct treatment for successful extubation from the ventilator during the first week of life in very low birth weight premature neonates.

Starting caffeine early in high-risk premature neonates has been associated with better long-term outcomes. However, it is not recommended to start caffeine prophylaxis in preterm neonates solely based on prematurity, as current literature supports this.

How serious is sleep apnea in babies?

Pediatric obstructive sleep apnea is a rare condition that can cause a failure to grow in infants and young children, increasing the risk of developing high blood pressure, high cholesterol, prediabetes, and other heart and blood vessel conditions. It is also rare for children with certain genetic conditions to have serious symptoms that can lead to death. However, complications can be managed with treatment.

The American Academy of Sleep Medicine has accredited the treatment of persistent pediatric obstructive sleep apnea. The condition is rare, and a gift to Mayo Clinic can have a 5X impact on AI innovation.

What is the first management of a neonate found to be apneic?

Apnea of prematurity is a condition characterized by respiratory pauses 20 seconds or pauses 20 seconds associated with bradycardia, central cyanosis, and oxygen saturation in neonates born at 37 weeks gestation. It may be caused by central nervous system immaturity or airway obstruction. Diagnosis is clinical and cardiorespiratory monitoring. Treatment involves respiratory stimulants for central apnea and head positioning for obstructive apnea.

The prognosis is excellent, with apnea resolving in most preterm neonates by 37 weeks postmenstrual age and in almost all preterm infants by 44 weeks postmenstrual age. Neonatal resuscitation skills are necessary for each birth, and gestational age and growth parameters help identify the risk of neonatal pathology.

What is the medication for apnea in newborns?

Neonatal apnea is treated by doctors using caffeine citrate, a medication that relaxes smooth muscles and stimulates the baby’s central nervous system and cardiac muscles. Other treatments include gently running the baby’s feet, positioning the baby in neutral positions for easier breathing, using suction to open the airways, and using a high-flow nasal cannula to breathe through the baby’s nostrils. If these treatments fail, a mechanical ventilation machine may be used to breathe for the baby in more extreme cases.