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Apnea in newborn infants: approach to management
Insights
Neonatal apnea affects 25% of premature infants. The pneumocardiogram aids in early detection and assessing treatment effectiveness for these critical cardio-respiratory events.
Area of Science:
- Neonatology
- Pediatric Pulmonology
- Cardiorespiratory Monitoring
Background:
- Neonatal apnea is common in premature infants (birth weight <1800g or 34 weeks gestational age), affecting approximately 25%.
- High incidence of apnea in infants later diagnosed with Sudden Infant Death Syndrome (SIDS) necessitates early identification of abnormal cardio-respiratory patterns.
Purpose of the Study:
- To review neonatal apnea.
- To present an institutional approach to the evaluation and management of neonatal apnea.
- To highlight the utility of the pneumocardiogram in detecting cardio-respiratory abnormalities and assessing pharmacologic therapy effectiveness.
Main Methods:
- Review of neonatal apnea literature.
- Description of an institutional approach to evaluation and management.
- Utilizing the pneumocardiogram for cardio-respiratory assessment.
Main Results:
- The pneumocardiogram is effective in detecting neonatal cardio-respiratory abnormalities.
- The pneumocardiogram is a useful tool for assessing the effectiveness of pharmacologic therapy for neonatal apnea.
Conclusions:
- Early identification of newborns with abnormal cardio-respiratory patterns is crucial.
- A coordinated multidisciplinary team approach is recommended for managing infants discharged on home apnea monitors.
- The pneumocardiogram is a valuable diagnostic and therapeutic assessment tool for neonatal apnea.
Abstract:
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.