Abstract
Hypoxia secondary to apnea has been suggested as one cause of neurological abnormalities in surviving premature infants. If hypoxia is, in part, responsible for brain damage, prevention by a simple and reliable means would be important. Using an impedance plethysmograph incorporating an alarm system the respiratory patterns of 15 normal premature infants and 7 infants recovering from the respiratory distress syndrome (RDS) weighing 862–2552 gm have been continuously monitred for 5–16 days. In 7 infants we obtained simultaneous ECG tracings. The duration of apneic periods >30 s, ECG changes, and arterial blood gases were measured and the appearance of the infant and the nature of the stimulus required to re-initiate respiration was recorded.
A total of 217 apneic periods of > 30 s were observed in the 22 infants. 6 infants (3 with healing RDS) had > 10 apneic episodes. Apneic periods began at end expiration and were rare in infants weighing > 1750 g. More frequent apneic periods at higher incubator temperatures were sometimes noted. When simultaneous ECG tracings were obtained marked cardiac slowing was noted within 10–15 s of the onset of apnea. Bradycardia (< 100) ensued within 20–30 s. Prolonged apnea (> 30 s) was associated with suggestive evidence of hypoxia (loss of muscle tone, cyanosis and mottling) whereas apnea of < 20 s duration was not. This study suggests apnea is more frequent than previously noted and is poorly tolerated after 20 s. Utilizing an apnea alarm, hypoxia with resultant brain damage may be prevented. (SPR)
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Daily, W., Meyer, H. & Klaus, M. 86 The Prevention of Prolonged Apnea as a Complication of Prematurity. Pediatr Res 1, 222 (1967). https://doi.org/10.1203/00006450-196705000-00093
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DOI: https://doi.org/10.1203/00006450-196705000-00093