Apnea of Prematurity

Eichenwald, Eric C.

doi:10.1542/peds.2015-3757

Cited by 288 publications

(179 citation statements)

References 38 publications

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“…Apnea of prematurity (AOP) is common in preterm infants and can be treated with pharmacological interventions and respiratory support [1, 2]. First-line therapy consists of methylxanthines, i.e.…”

Section: Introductionmentioning

confidence: 99%

Doxapram Treatment and Diaphragmatic Activity in Preterm Infants

et al. 2018

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Background: Doxapram is a treatment option for severe apnea of prematurity (AOP). However, the effect of doxapram on the diaphragm, the main respiratory muscle, is not known. Objectives: To investigate the effect of doxapram on diaphragmatic activity measured with transcutaneous electromyography of the diaphragm (dEMG). Methods: A pilot study was conducted in a tertiary neonatal intensive care unit. Diaphragmatic activity was measured from 30 min before up to 3 h after the start of doxapram treatment. dEMG parameters were compared to baseline (5 min before doxapram treatment) and at 15, 60, 120 and 180 min after the start of doxapram infusion. Results: Eleven preterm infants were included with a mean gestational age of 25.5 ± 1.2 weeks and birth weight of 831 ± 129 g. The amplitude_dEMG, peak_dEMG and tonic_dEMG values did not change in the 3 h after the start of doxapram infusion compared to baseline. Clinically, the number of apnea episodes in the 24 h after doxapram treatment decreased significantly. Conclusion: Doxapram infusion does not alter diaphragmatic activity measured with transcutaneous dEMG in preterm infants with AOP, indicating that its working mechanism is primarily on respiratory drive and not on respiratory muscle activity.

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Section: Introductionmentioning

confidence: 99%

Doxapram Treatment and Diaphragmatic Activity in Preterm Infants

et al. 2018

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“…Apnea was defined as a cessation of respiratory air flow for 20 seconds or longer, regardless of the clinical consequences or episodes of cessation of breathing of shorter duration which have cardiocirculatory repercussions (bradycardia and/or hypoxemia) (20).…”

Section: Methodsmentioning

confidence: 99%

Risk Factors of Retinopathy of Prematurity Associated with Delayed Retinal Vascular Development

et al. 2017

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Objectives: To assess risk factors of retinopathy of prematurity leading to delayed retinal vascularization in the first stage of ROP. Methods:A retrospective study (2000 -2016) was performed in 275 infants who were born at a gestational age of ≤ 32 weeks. Delayed vascular development was calculated as the difference in avascular area measured in terms of disc diameters between patients with risk factor and those with no risk factor. Results:Intrauterine fetal demise of one twin, apnea, exchange tranfusion and intubation days (≥ 10 days) lead to delayed retinal vascularization of 1.74, 1.58, 1.17, and 1.11 disc diameters and of 3.35, 3.04, 2.25 and 2.13 weeks respectively. Delayed retinal vascular development was less than 1 disc diameter in other factors such as HS-PDA, sepsis, degree of hyaline membrane ≥ III, cerebral hemorrhage, birth weight (every 100 g less), gestational age (every week less), postnatal weight gain (every 1 g less/day) and cerebral hemorrhage. However, since these factors are quantitative (birth weight, gestational age and postnatal weight gain), the greater the adverse effect, the greater the delay will be. Conclusions:Intrauterine fetal demise of one twin, apnea, exchange tranfusion and intubation days (≥ 10 days) lead to delayed retinal vascular development more than 1 disc diameter at 4 -6 weeks of postnatal life.

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“…Apnea of prematurity (AOP) is a very common condition seen in patients in the neonatal intensive care unit, 1 reportedly occurring in 75% to 100% of those born before 28-weeks gestation and 60% to 80% of those born between 28 and 30 completed weeks. 2,3 While, in most cases, the problem resolves, it may persist in some infants well beyond term corrected age, often prolonging hospital stay.…”

Section: Introductionmentioning

confidence: 99%

“…4 It is defined as a cessation of breathing for at least 20 seconds, or shorter if accompanied by bradycardia and/or desaturations. 1 Very low birthweight (VLBW) infants may have multiple apneic events per day, of which many are accompanied by hypoxemia and bradycardia. 5 Currently, standard first-line therapy for AOP is caffeine citrate, which is dosed daily and given either intravenously or orally.…”

Section: Introductionmentioning

confidence: 99%

NAVA—synchronized compared to nonsynchronized noninvasive ventilation for apnea, bradycardia, and desaturation events in VLBW infants

Tabacaru

Moores

Khoury

et al. 2019

Pediatric Pulmonology

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Neurally adjusted ventilatory assistance (NAVA) can overcome technical difficulties with synchronizing noninvasive ventilation breaths with the patient, a modality often used in very low birthweight infants (VLBW) with apnea of prematurity (AOP). This study is a retrospective single‐center investigation into whether NAVA‐synchronized noninvasive (niNAVA) ventilation is better than nonsynchronized (nasal intermittent positive pressure ventilation [nIPPV]) for symptomatic apnea in VLBW infants. Nursing records of apnea, bradycardia, and/or desaturations were abstracted from the electronic medical records of 108 VLBW infants admitted to the neonatal intensive care unit (NICU) from 2015 to 2017 who received either of the two modalities, 61 epochs of niNAVA totaling 488 days and 103 epochs of nIPPV totaling 886.5 days. niNAVA was associated with a significant reduction in the number of isolated bradycardic events/day (0.48 ± 0.14 vs 1.35 ± 0.27; P = .019) and overall bradycardias/day (2.42 ± 0.47 vs 4.02 ± 0.53; P = .042) and there were more epochs with no events with niNAVA compared with nIPPV (23.0% vs 6.8%; P = .004). These results justify a prospective trial of NAVA‐synchronized noninvasive ventilation for VLBW infants with caffeine‐resistant AOP.

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Apnea of Prematurity

Cited by 288 publications

References 38 publications

Doxapram Treatment and Diaphragmatic Activity in Preterm Infants

Doxapram Treatment and Diaphragmatic Activity in Preterm Infants

Risk Factors of Retinopathy of Prematurity Associated with Delayed Retinal Vascular Development

NAVA—synchronized compared to nonsynchronized noninvasive ventilation for apnea, bradycardia, and desaturation events in VLBW infants

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