Abstract
Apnea (Greek; a-pnoia) which means no breath, is a common problem in neonatal intensive care. Usually apnea is defined as the cessation of breathing during a certain period of time. In newborn infants the duration of apnea however varies with the patterns of breathing that range from regular breathing without apnea to extremely irregular breathing with prolonged apneic episodes. Several patterns of breathing are found in newborn infants. Regular breathing with almost equal breath-to-breath intervals and amplitudes (depth of breath) is common in mature newborn infants especially during non-REM (quiet) sleep. Irregular breathing with marked variability in breath-to-breath intervals and amplitudes, in mature newborn infants usually observed during REM (active) sleep, is common in preterm infants. Periodic breathing, defined by cessation of breathing for 3 to 10 seconds occurring at regular intervals alternating with bursts of breahing activity is seen in both mature and preterm newborn infants at sleep (1). The pattern of breathing of preterm infants is mostly irregular and periodic. With increasing gestational age the pattern of breathing becomes more regular and less periodic.
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References
Hoppenbrouwers T, Hodgman JE, Harper RM, Hofman E, Sterman MB, Mc Ginty DJ: Polygraphic studies of normal infants during the first six months of life. III. Incidence of apnea and periodic breathing. Pediatrics 60:418, 1977
Hoppenbrouwers T, Hodgman JE, Kazuko Arakawa, Harper R, Sterman B: Respiration during the first six months of life in normal infants. III. Computer identification of breathing pauses. Pediatr Res 14:1230, 1980
Guilleminault C, Periata R, Souquet M, Dement WC: Apneas during sleep in infants: possible relationship with sudden infant death syndrome. Science 190:677, 1975
Oommen PM, Roberts JL, Thach BT: Pharyngeal airway obstruction in preterm infants during mixed and obstructive apnea. J Pediatr 100:964, 1982
Daily WJ, Klaus M, Meyer HBP: Apnea in premature infants: monitoring, incidence, heart reate changes and effect of environmental temperature. Pediatrics 43:510, 1969
Buckfield PM: Neonatal at risk factors. NZ Med J 75:266, 1972
Smith ML, Milner AD: Bradycardia and associated respiratory changes in neonates. Arch Dis Child 56:645, 1981
Rigatto H, Brady JP, de La Torre Verduzco R: Chemoreceptor reflexes in preterm infants. II. The effect of gestational and postnatal age on the ventilatory response to inhaled carbondioxide. Pediatrics 55:614, 1975
Rigatto H, Brady JP: Periodic breathing and apnea in preterm infants. II. Hypoxia as a primary event. Pediatrics 50:219, 1972
Rigatto H, Brady JP, de La Torre Verduzco R: Chemoreceptor reflexes in preterm infants. I. The effect of gestational and postnatal age on the ventilatory response to inhalation of 100% and 15% oxygen. Pediatrics 55:604, 1975
Rigatto H: Apnea. In: Oh W(ed), The Newborn. Pediatric Clinics of North America, Vol 29. Saunders, Philadelphia, p 5, 1982
Martin RJ, Okken A, Rubin D: Arterial oxygen tension during active and quiet sleep in the normal neonate. J Pediat 94:271, 1979
Hanson N, Okken A: Transcutaneos oxygen tension of newborn infants in different behavioural states. Pediatr Res 14:91, 1980
Knill R, Bryan AC: An intercostal-phrenic inhibitory reflex in human newborn infants. J Appl Physiol 40:352, 1976
Boychuck RB, Seshia MMK, Rigatto H: The effect of gestational age on the effective elastance of the respiratory system. Pediatr Res 11:797, 1977
Bryan AC: Diaphragmatic fatique in newborns. Am Rev Resp Dis 119:143, 1979
Heymann MA, Rudolph AM, Silverman NH: Closure of the ductus arteriosus in premature infants by inhibition of prostaglandin synthesis. N Engl J Med 295:530, 1976
Fanaroff AA, Martin RJ: The respiratory system: other pulmonary problemes. In: Fanaroff AA, Martin RJ (ed), Behrman’s Neonatal-perinatal Medicine: Diseases of the Fetus and Infant, 3rd ed. Mosby, St Louis, 1983
Perlstein H, Edward NH, Sutherland J: Apnea in premature infants and incubator air temperature changes. N Engl J Med 282:461, 1970
Korner AF, Kraemer HC, Haffner ME et al.: Effects of waterbed flotation on premature infants: a pilot study. Pediatrics 56:361, 1975
Marshall TA, Kattwinkel MD: Functional residual capacity and oxygen tension in apnea of prematurity. J Pediatr 98:479, 1981
Aranda JV, Sitar DS, Parson WD et al.: Pharmacokinetic aspects of theophylline in premature newborns. N Engl J Med 295:413, 1976
Okken A, Rubin IL, Martin RJ: Intermittent bag ventilation of preterm infants on continuous positive airway pressure: the effect on transcutaneous PO2. J Pediatr 93:279, 1978
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© 1984 Martinus Nijhoff Publishers, Dordrecht
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Okken, A. (1984). Recurrent Apnea in Newborn Infants. In: Prakash, O. (eds) Critical Care of the Child. Developments in Critical Care Medicine and Anesthesiology, vol 8. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-6036-7_10
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DOI: https://doi.org/10.1007/978-94-009-6036-7_10
Publisher Name: Springer, Dordrecht
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