Abstract
Introduction: The apneas in the NB occur as an initial sign of a variety of different pathologies. The IP processes the information resulting from the chest wall movements, the oronasal flow, the heart rate (HR) and the O2 saturation by means of a multi-channel recorder. This tool helps identify the different types of apneas: central apneas (CA), obstructive apneas (OA), and mixed apneas (MA) – and their implications on HR and saturation. Objective: To present the conclusions resulting from a study in which a cohort of NB was monitored by IP.
Methods: The IP was used to evaluate NB with ALTE, severe episodes of apnea and/or bradycardia and/or desaturation without respiratory ventilation or CPAP. We define CA as the absence of air flow and chest wall movements; OA as the absence of air flow when the chest wall movements are uninterrupted; MA as the combination of the former. We considered bradycardia as HR? 80 beats/minute for ? than 5sec., and desaturation as a register ? 85% for ? than 5sec. Periodic breathing (PB) is defined as a breathing pause that lasts just a few seconds and it is combined with regular breathing.The study was performed during spontaneous sleep, because sleep deprivation increases OA and sympathic tone.
Results: During a period of 40 months, 41 IP were performed to 38 NB with 800 gr. to 4,350 gr. birth weight. The average time of the IP was 10,3 hrs. OA was diagnosed in 15 premature babies and 11 full-term infants (FTI). The etiology of the OA in the premature babies was associated with a potential collapse of the upper airway (UA), except the infants diagnosed with laryngospasm due to Gastroesophageal Reflux (GER) and a patient diagnosed with microretrognatia. The FTI with OA presented: GER (n:2). Microretrognatia (n:3), increase in the soft parts of the cavum (1), upper airway infection (n:4), laryngomalasia (n:2) and bilateral vocal cord paralysis (n:1). PB with desaturation was diagnosed in 5 premature babies. CA was observed (? of P90) in 5 premature babies, in 2 FTI with Arnold-Chiari Malformation and in 1 FTI with congenital hypoventilation.
Conclusions: The premature babies who were studied presented in most of the cases OA.The etiology of the OA was diagnosed in every FTI.The IP allowed us to clearly identify each type of apnea, as well as understand the physiopathology of the events, resulting in a more rational performance of ancillary studies.
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Jenik, A., Mariani, G., Fustiñana, C. et al. 22 Impedance Pneumography (IP): A Useful Method in the Differential Diagnosis of the Apneas in the Newborn (NB). Pediatr Res 57, 923 (2005). https://doi.org/10.1203/00006450-200506000-00050
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DOI: https://doi.org/10.1203/00006450-200506000-00050