Apnea of Prematurity Pharmacotherapy
Apnea of Prematurity Pharmacotherapy
Apnea of prematurity (AOP) commonly occurs in infants of less than 37 weeks' gestation and is characterized by brief episodes of breathing cessation lasting 20 seconds or less with associated bradycardia or cyanosis. It is a diagnosis of exclusion that can only be confirmed once alternate causes of apnea (e.g., sepsis, metabolic disorders, central nervous system [CNS] pathology) have been excluded. The apnea can be classified as being of central origin, obstructive, or mixed type. Periodic breathing represents a normal occurrence of breathing during sleep and is often confused with apnea. (The different types of apnea and periodic breathing are categorized in Table 1.) Central apnea refers to the failure of the central CNS to initiate respiratory effort secondary to immaturity of the neurologic pathways. Obstructive apnea, most commonly due to collapse of the pharyngeal airway, results in mechanical interference with respiratory efforts and often leads to bradycardia. Mixed-type apnea is a combination of both central and obstructive apneas. Studies have shown that the majority of apnea events (~50%) in preterm infants are of mixed origin, 40% are of central origin, and 10% are purely obstructive in origin.
Abstract and Introduction
Introduction
Apnea of prematurity (AOP) commonly occurs in infants of less than 37 weeks' gestation and is characterized by brief episodes of breathing cessation lasting 20 seconds or less with associated bradycardia or cyanosis. It is a diagnosis of exclusion that can only be confirmed once alternate causes of apnea (e.g., sepsis, metabolic disorders, central nervous system [CNS] pathology) have been excluded. The apnea can be classified as being of central origin, obstructive, or mixed type. Periodic breathing represents a normal occurrence of breathing during sleep and is often confused with apnea. (The different types of apnea and periodic breathing are categorized in Table 1.) Central apnea refers to the failure of the central CNS to initiate respiratory effort secondary to immaturity of the neurologic pathways. Obstructive apnea, most commonly due to collapse of the pharyngeal airway, results in mechanical interference with respiratory efforts and often leads to bradycardia. Mixed-type apnea is a combination of both central and obstructive apneas. Studies have shown that the majority of apnea events (~50%) in preterm infants are of mixed origin, 40% are of central origin, and 10% are purely obstructive in origin.
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