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Apnea, transient episodes of bradycardia, and periodic breathing in preterm infants
J E Hodgman1, F Gonzalez, T Hoppenbrouwers
1University of Southern California School of Medicine.
Insights
Central apnea and transient bradycardia are common in healthy premature infants. These findings suggest these breathing patterns are normal, not abnormal, in this population.
Area of Science:
- Neonatal Physiology
- Respiratory Control in Infants
Background:
- Premature infants often exhibit irregular breathing patterns.
- Central apnea, transient episodes of bradycardia (TEB), and periodic breathing are common concerns.
Purpose of the Study:
- To investigate the occurrence and significance of central apnea, TEB, and periodic breathing in healthy premature infants.
- To determine if these respiratory patterns are normal findings in this population.
Main Methods:
- Studied 66 healthy premature infants (32-36 weeks postconceptual age).
- Conducted 8-hour cardiorespiratory recordings.
- Visually analyzed recordings for central apnea (≥15 seconds), TEB, and periodic breathing.
Main Results:
- Central apnea (≥15 seconds) occurred in nearly 50% of infants.
- TEB were frequent, mostly without central apnea.
- All but five longer apneic episodes were associated with TEB.
- Infants spent up to 40% of recording time in periodic breathing.
Conclusions:
- The high frequency of these patterns suggests they are normal in healthy premature infants.
- Brief apneic episodes accompanied by TEB should not be considered abnormal.
Abstract:
The occurrence of central apnea of 15 seconds or longer, transient episodes of bradycardia (TEB), and periodic breathing were studied in 66 healthy premature infants when at least 1 week old and between 32 and 36 weeks postconceptual age. Eight-hour cardiorespiratory recordings were visually scanned for the presence of these patterns. Central apnea of 15 seconds or longer was seen in almost half of the infants. The TEB were numerous, and the majority were not associated with central apnea; however, all but five of the apneic episodes that lasted 15 seconds or longer were accompanied by a TEB. Infants spent as much as 40% of their time in periodic breathing. The frequency with which these patterns are seen in healthy premature infants strongly suggests that they are normal findings. Our results do not support the opinion that brief periods of apnea are abnormal when accompanied by a TEB.