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Laryngeal oedema in neonatal apnoea and bradycardia syndrome (a pilot study)

Danièle Vermeylen1, Patricia Franco, Yves Hennequin

  • 1Neonatal Intensive Care Unit, Erasmus Hospital, Free University of Brussels (ULB), Brussels, Belgium. dvermeyl@ulb.ac.be

Early Human Development
|April 9, 2005
PubMed

Insights

Laryngeal edema may cause recurrent apneas, bradycardias, and desaturations in preterm infants. Corticosteroid treatment, diagnosed via fiberoptic endoscopy, effectively resolves these breathing events.

Area of Science:

  • Neonatal Medicine
  • Pediatric Pulmonology
  • Otolaryngology

Background:

  • Preterm infants often experience recurrent apneas, bradycardias, and desaturations (ABD) despite standard treatments.
  • These events pose a risk for transient brain hypoxia and potential neurological injury.
  • The underlying causes of persistent ABD in otherwise healthy preterm infants require further investigation.

Purpose of the Study:

  • To investigate the role of laryngeal edema as a cause of recurrent ABD in preterm infants.
  • To evaluate the efficacy of corticosteroid treatment for laryngeal edema-induced ABD.
  • To assess the diagnostic utility of fiberoptic laryngeal endoscopy.

Main Methods:

  • Twelve preterm infants with recurrent ABD underwent fiberoptic laryngeal endoscopy.
  • Laryngeal examination was performed at a median postconceptional age of 34 weeks.
  • Infants were treated with inhaled corticosteroids, with some also receiving oral dexamethasone.

Main Results:

  • All infants presented with severe laryngeal edema, indicative of potential obstructive breathing.
  • Corticosteroid treatment led to clinical improvement in all infants.
  • Recurrence of ABD was observed in 25% of infants after dexamethasone cessation, with no immediate side effects noted.

Conclusions:

  • Laryngeal edema is a potential cause of recurrent ABD in preterm newborns.
  • Esophageal reflux and feeding tubes may contribute to laryngeal edema.
  • Atraumatic fiberoptic fibroscopy is a viable diagnostic tool, and corticosteroids offer an effective treatment.
Abstract

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