Apnea in Neonates - Concepts and Controversies

Santosh Kumar K
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Abstract

Apnoea of prematurity (AOP) is a common problem affecting premature infants. Apnoea is defined as cessation of breathing for more than 20 seconds or for lesser duration when associated with bradycardia and desaturation. The most likely and accepted pathogenesis is the “physiologic” immaturity of respiratory control in the neonates. The physiological immaturities include altered ventilatory responses to hypoxia, hypercapnia, and altered sleep states. Other hypotheses include gastroesophageal reflux and anaemia which are still controversial. Three types have been identified namely obstructive, central and mixed types of apnoea. Management options include the use of supplemental oxygen, position chages and drug therapy with methyxanthines. Other supportive therapies include kangaroo care, packed cell transfusions. The long term neurodevelopmental consequences of AOP and its treatment still needs to be studied further..
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新生儿呼吸暂停-概念和争议
早产儿呼吸暂停(AOP)是影响早产儿的常见问题。呼吸暂停被定义为呼吸停止超过20秒或持续时间更短,并伴有心动过缓和血饱和度过低。最可能和公认的发病机制是新生儿呼吸控制的“生理性”不成熟。生理上的不成熟包括对缺氧、高碳酸血症的通气反应改变和睡眠状态改变。其他假说包括胃食管反流和贫血,这些假说仍有争议。已经确定了三种类型,即阻塞性、中枢性和混合型呼吸暂停。管理方案包括使用补充氧气,体位改变和甲黄嘌呤药物治疗。其他支持性治疗包括袋鼠式护理、填充细胞输注。AOP及其治疗的长期神经发育后果仍需要进一步研究。
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