<abstract xmlns="http://www.w3.org/1999/xhtml"><p>Apnea, especially in preterm newborns (AoP) is one of the common problems encountered at neonatal units.
Numerous factors are likely to play a role in the etiology of apnea. Recent data sugest a role for genetic predisposition
of AoP. It seems, that physiological rather than pathological immaturity of the respiratory, or cardiorespiratory
control, play a major part in the pathophysiology of AoP. Immaturity of the brainstem, cerebral cortex, receptors
of the lungs and the airways as well as of the chemoreceptors contribute to the development of apnea in
preterm newborns. Several neurotransmitters (GABA, adenosin, endorphins) and their maturational changes are
including in pathogenesis of apnea, too. The instability of the upper airway in preterm infants, asynchrony of musculature
of the upper airway and diaphragm, pathological changes in the upper airway and malformations of the
central nervous system might also contribute to the occurrence and severity of AoP.
In newborns, apnea occurs more frequently in active sleep than in quiet sleep and the frequency of apnea
in active sleep is higher in the warm conditions. Durations of apnea correlate with the body heat loss.
Cardiovascular changes during apnea - bradycardia, peripheral vasoconstriction and various changes in
peripheral blood flow and pressure occur together with changes in ECG. The standard clinical management of
apnea includes non-pharmacological treatment (eliciting arousal reactions and reflex breathing by mechanical
skin, or mucosa stimulations), pharmacological treatment (methylxanthines are preferred) and application of continuous
positive airway pressure (CPAP) or in severe apnea - mechanical ventilation.</p></abstract>

Apnea, especially in preterm newborns (AoP) is one of the common problems encountered at neonatal units.
Numerous factors are likely to play a role in the etiology of apnea. Recent data sugest a role for genetic predisposition
of AoP. It seems, that physiological rather than pathological immaturity of the respiratory, or cardiorespiratory
control, play a major part in the pathophysiology of AoP. Immaturity of the brainstem, cerebral cortex, receptors
of the lungs and the airways as well as of the chemoreceptors contribute to the development of apnea in
preterm newborns. Several neurotransmitters (GABA, adenosin, endorphins) and their maturational changes are
including in pathogenesis of apnea, too. The instability of the upper airway in preterm infants, asynchrony of musculature
of the upper airway and diaphragm, pathological changes in the upper airway and malformations of the
central nervous system might also contribute to the occurrence and severity of AoP.
In newborns, apnea occurs more frequently in active sleep than in quiet sleep and the frequency of apnea
in active sleep is higher in the warm conditions. Durations of apnea correlate with the body heat loss.
Cardiovascular changes during apnea - bradycardia, peripheral vasoconstriction and various changes in
peripheral blood flow and pressure occur together with changes in ECG. The standard clinical management of
apnea includes non-pharmacological treatment (eliciting arousal reactions and reflex breathing by mechanical
skin, or mucosa stimulations), pharmacological treatment (methylxanthines are preferred) and application of continuous
positive airway pressure (CPAP) or in severe apnea - mechanical ventilation.

Apnea in preterm newborns: determinants, pathophysiology, effects on cardiovascular parameters and treatment

Clinic of Neonatology Comenius
University and University Hospital Martin, Slovakia

Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius
University and University Hospital Martin, Slovakia

Acta Medica Martiniana

Apnea, especially in preterm newborns (AoP) is one of the common problems encountered at neonatal units.
Numerous factors are likely to play a role in the...

Apnea in preterm newborns: determinants, pathophysiology, effects on cardiovascular parameters and treatment

Published Online: Feb 25, 2014

Page range: 5 - 17

DOI: https://doi.org/10.2478/acm-2013-0017

Keywords
apnea, apnea of prematurity, newborn, immaturity, chemoreflexes, heart rate, bradycardia, blood pressure, oxygen desaturation, methylxanthines, treatment of apnea

This content is open access.

Apnea in preterm newborns: determinants, pathophysiology, effects on cardiovascular parameters and treatment

Published Online: Feb 25, 2014

Page range: 5 - 17

DOI: https://doi.org/10.2478/acm-2013-0017

Keywordsapnea, apnea of prematurity, newborn, immaturity, chemoreflexes, heart rate, bradycardia, blood pressure, oxygen desaturation, methylxanthines, treatment of apnea

This content is open access.

Keywords
apnea, apnea of prematurity, newborn, immaturity, chemoreflexes, heart rate, bradycardia, blood pressure, oxygen desaturation, methylxanthines, treatment of apnea