apnea of prematurity


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Related to apnea of prematurity: respiratory distress syndrome

apnea of prematurity

Abbreviation: AOP
A condition of the premature newborn, marked by repeated episodes of apnea lasting longer than 20 sec. The diagnosis of AOP is one of exclusion, made when no treatable cause can be found. Increased frequency of apneic episodes directly relates to the degree of prematurity. AOP is not an independent risk factor for sudden infant death syndrome. Apneic episodes may result in bradycardia, hypoxia, and respiratory acidosis.

Treatment

There is no specific treatment. Initial efforts should begin with the least-invasive method. Tactile stimulation is often successful with early recognition. When gentle stimulation does not produce a response, bag and mask ventilation is initiated. Methylxanthines such as caffeine, theophylline, and aminophylline are helpful.

Patient care

Care includes maintenance of a neutral thermal environment, avoidance of prolonged oral feedings, use of tactile stimulation early in the apneic episode, and ventilatory support as needed. The infant who has experienced and survived an episode of apnea is maintained on cardiac and respiratory monitoring devices. Before discharge, parents are taught cardiopulmonary resuscitation, use of monitoring equipment, and how to recognize signs of medication toxicity if medications are used.

See also: apnea
References in periodicals archive ?
Results of our study revealed that caffeine is more effective than Theophylline in treatment of apnea of prematurity.
Doxapram Treatment for Apnea of Prematurity: A Systematic Review.
Caffeine versus theophylline for apnea of prematurity: A randomised controlled trial.
Comparison between Caffeine and Theophylline Therapy for Apnea of Prematurity. Neonatal Med.
Comparative Efficacy and Safety of Caffeine and Aminophylline for Apnea of Prematurity in Preterm (a$?34 weeks) Neonates: A randomized controlled trial.
In the earlier CAP (Caffeine for Apnea of Prematurity) trial, 793 premature infants with birthweights of 500-1,250 g were randomly assigned to receive either caffeine or placebo until therapy for apnea of prematurity was no longer needed.
Major finding: No differences were seen in later childhood between children with apnea of prematurity treated with caffeine or placebo in terms of sleep pathology, but apnea of prematurity itself increases risk for obstructive sleep apnea and restless sleep in later childhood.
Comprehensive care and anticipatory guidance can help eliminate masking by apnea of prematurity of serious conditions that initially present as an ALTE.
Caffeine citrate: a review of its use in apnea of prematurity. Pediatr Drugs 2001; 3: 61-79.
Caffeine citrate for the treatment of apnea of prematurity: a double-blind, placebo-controlled study.
Survival without disability to age 5 years after neonatal caffeine therapy for apnea of prematurity. JAMA.
(1-6) None of these case-control studies found apnea of prematurity to be a risk factor for SIDS.