A typical case of apnea occurring in a premature infant is presented. The pathophysiology of apnea as well as its incidence and etiology are described. Treatment is also discussed, with particular emphasis on the use of theophylline.
Get full access to this article
View all access options for this article.
References
1.
DailyW. J. R.: Apnea in Premature Infants: Monitoring, Incidence, Heart Rate Canges, and an Effect of Environmental Temperature, Pediatrics43: 510–519 (Apr.) 1969.
2.
LuceyJ. F.: The Xanthine Treatment of Apnea of Prematurity, Pediatrics55: 584–586 (Oct.) 1975.
3.
BradyJ. P.BrooksJ. G.: The Control of Breathing, InRudolphA. M.BarnettH. L.EinhornA. H., (Eds.), Pediatrics16th Ed., Appleton-Century-Crofts, New York, N.Y., p. 1515, 1977.
4.
BrazieJ. V.LubchencoL. O.: The Newborn Infant, InKempeC. H. (Eds.), Current Pediatric Diagnosis and Treatment, 4th Ed., Lange Medical Publications, Los Altos, California, pp. 66–67, 1976.
HuchR.: Reliability of Transcutaneous Monitoring of Arterial pO2 in Newborn Infants, Arch. Dis. Child.49: 213–218 (Mar.) 1974.
7.
GabrielM.: Apneic Spells and Sleep States in Preterm Infants, Pediatrics57: 142–147 (Jan.) 1976.
8.
GabrielM.AlbaniM.: Rapid Eye Movement Sleep, Apnea, and Cardiac Slowing Influenced by Phenobarbital Administration in the Neonate, Pediatrics60: 426–430 (Oct.) 1977.
9.
KattwinkelJ.: Neonatal Apnea: Pathogenesis and Therapy, J. Pediatr.90: 342–347 (Mar.) 1977.
10.
VolpeJ. J., Neurological Disorders, InAveryG. B. (Ed.), Neonatology: Pathophysiology and Management of the Newborn, J. B. Lippincott Co., Philadelphia, PA, pp. 741–744, 1975.
11.
CordersL.HonE.: Neonatal Bradycardia Following Nasopharyngeal Stimulation, J. Pediatr.78: 441–447 (Mar.) 1971.
12.
DowningS. E.LeeJ. C.: Laryngeal Chemosensitivity: A Possible Mechanism for Sudden Infant Death, Pediatrics55: 640–649 (May) 1975.
13.
SchulteF. J.: Rapid Eye Movement Sleep, Motor-Neuron Inhibition, and Apneic Spells in Preterm Infants, Pediatr. Res.11: 709–813 (June) 1977.
14.
KrausA. N.: Sleep State, Apnea and Bradycardia in Pre-Term Infants, Dev. Med. Child. Neurol.19: 160–168 (Apr.) 1977.
15.
ArandaJ. V.: Efficacy of Caffeine in Treatment of Apnea in the Low-Birth-Weight Infant, J. Pediatr.90: 467–472 (Mar.) 1977.
16.
DowellA. R.: Effect of Aminophylline on Respiratory-Center Sensitivity in Cheyne-Stokes Respiration and in Pulmonary Emphysema, N. Engl. J. Med.273: 1447–1453 (Dec. 30) 1965.
17.
MaraisO. A. S.McMichaelJ.: Theophylline — Ethylenediamine in Cheyne-Stokes Respiration, Lancet233: 437–440 (Aug. 21) 1937.
18.
DaviM. J., Physiologic Changes Induced by Theophylline in the Treatment of Apnea in Preterm Infants, J. Pediatr.92: 91–95 (Jan.) 1978.
19.
KuzemkoJ. A.PaalaJ.: Apnoeic Attacks in the Newborn Treated with Aminophylline, Arch. Dis. Child.48: 404–406 (May) 1973.
20.
UauyR.: Treatment of Severe Apnea in Prematures with Orally Administered Theophylline, Pediatrics55: 595–598 (May) 1975.
21.
ShannonD. C.: Prevention of Apnea and Bradycardia in Low-Birthweight Infants, Pediatrics55: 589–594 (May) 1975.
22.
BednarekF. J.RoloffD. W.: Treatment of Apnea of Prematurity with Aminophylline, Pediatrics58: 335–339 (Sept.) 1976.
23.
MorensD. M.: The Use of Xanthines in Treating Apnea of Prematurity, Pediatrics56: 617–618 (Oct.) 1975.
24.
NobelP. A.LightG. S.: Theophylline-Induced Diuresis in the Neonate, J. Pediatr.90: 825–826 (May) 1977.
25.
ArandaJ. V.: Metabolic Effect of Theophylline in the Premature Neonate, J. Pediatr.89: 833–834 (Nov.) 1976.
26.
KuzemkoJ. A.: The Use of Xanthines in Treating Apnea of Prematurity, Pediatrics57: 293 (Feb.) 1977.
27.
EllisE. F.: Pharmacokinetics of Theophylline in Children with Asthma, Pediatrics58: 542–547 (Oct.) 1976.
28.
LoughnanP. M.: Pharmacokinetic Analysis of the Disposition of Intravenous Theophylline in Young Children, J. Pediatr.88: 874–879 (May) 1976.
29.
WalsonP. D.: Intrapatient Variability in Theophylline Kinetics, J. Pediatr.91: 321–324 (Aug.) 1977.
30.
GiacoiaG.: Theophylline Pharmacokinetics in Premature Infants with Apnea, J. Pediatr.89: 829–832 (Nov.) 1976.
31.
ArandaJ. V.: Pharmacokinetic Aspects of Theophylline in Premature Newborns, N. Engl. J. Med.295: 413–416 (Aug. 19) 1976.
JenneJ. W.: Apparent Theophylline Half-Life Fluctuations During Treatment of Acute Left Ventricular Failure, Am. J. Hosp. Pharm.34: 408–409 (Apr.) 1977.
34.
PiafskyK. M.: Theophylline Disposition in Patients with Hepatic Cirrhosis, N. Engl. J. Med.296: 1495–1497 (June 30) 1977.