Apnoea

CHAPTER 20 Apnoea



David Cartwright, Mark Davies



Background


Definition:


• either 20 seconds of zero flow in or out of the lungs; or

• 10 seconds of zero flow accompanied by desaturation or bradycardia.

An episode of apnoea may or may not be accompanied by bradycardia and cyanosis.


Causes of apnoea in newborns:


• infection — meningitis, septicaemia, pneumonia, necrotising enterocolitis, viral upper respiratory tract infection (especially respiratory syncytial virus, RSV)

• hypoxia

• acidosis

• seizures

• metabolic disturbances — hypoglycaemia, hyponatraemia, hypocalcaemia

• intraventricular haemorrhage

• airway obstruction

• gastric or abdominal distension

• gastro-oesophageal reflux, including lowered pH in mid-oesophagus

• apnoea of prematurity (many of the above may contribute to this).

Consequences of apnoea:


• hypoxia / acidosis

• progressive atelectasis

• gastro-oesophageal reflux

• aspiration.

Investigations may include:


• blood sugar level (BSL), arterial blood gas (ABG), urea and electrolytes (U&Es), calcium, magnesium, blood culture, full blood count (FBC) and film examination
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Jul 18, 2016 | Posted by in PEDIATRICS | Comments Off on Apnoea

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