Apnoea

Published on 03/06/2015 by admin

Filed under Neonatal - Perinatal Medicine

Last modified 03/06/2015

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CHAPTER 20 Apnoea

David Cartwright, Mark Davies

Background

Definition:

• either 20 seconds of zero flow in or out of the lungs; or

• 10 seconds of zero flow accompanied by desaturation or bradycardia.

An episode of apnoea may or may not be accompanied by bradycardia and cyanosis.

Causes of apnoea in newborns:

• infection — meningitis, septicaemia, pneumonia, necrotising enterocolitis, viral upper respiratory tract infection (especially respiratory syncytial virus, RSV)

• metabolic disturbances — hypoglycaemia, hyponatraemia, hypocalcaemia

• intraventricular haemorrhage

• airway obstruction

• gastric or abdominal distension

• gastro-oesophageal reflux, including lowered pH in mid-oesophagus

• apnoea of prematurity (many of the above may contribute to this).

Consequences of apnoea:

• hypoxia / acidosis

• progressive atelectasis

• gastro-oesophageal reflux

• aspiration.

Investigations may include:

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