Apnea in newborn infants: approach to management

Approximately 25% of infants with birth weights less than 1800 g or infants of about 34 weeks gestational age have an apneic episode. This, and the known high incidence of apneas in infants who subsequently are victims of sudden infant death syndrome, has led to aggressive attempts at early identification of newborns with abnormal cardio-respiratory patterns. We have found the pneumocardiogram to be effective in detecting cardio-respiratory abnormality in the newborn, and a very useful tool in the assessment of the effectiveness of pharmacologic therapy of neonatal apnea. Infants who are discharged on a home apnea monitor should be managed, utilizing a coordinated multidisciplinary team approach, that includes 24 h availability of a physician, technician, community health nurse, social worker and, when possible, a member of a parent support group. This paper presents a review of neonatal apnea and our institutional approach to its evaluation and management.