Continuous positive airway pressure selectively reduces obstructive apnea in preterm infants

Miller, Martha J.; Carlo, Waldemar A.; Martin, Richard J.

doi:10.1016/s0022-3476(85)80475-3

Cited by 168 publications

(57 citation statements)

References 23 publications

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“…Each apnea was classified as mixed, obstructive, or central according to the criteria previously used in studies from this laboratory (10). Mixed apnea was characterized by obstructed inspiratory efforts as well as a central pause greater than or equal to 2 s in duration.…”

Section: Methodsmentioning

confidence: 99%

A Comparison of Swallowing During Apnea and Periodic Breathing in Premature Infants

Miller

DiFiore

1995

Pediatr Res

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Periodic breathing and apnea are two forms of ventilatory instability which are commonly observed in premature infants. This study was undertaken to characterize the pattern of swallowing during apnea and compare this pattern to that present during periodic breathing. We assessed the frequency and distribution of swallows during the respiratory pauses of apnea and periodic breathing in 22 premature infants birth weight 1.2 2 0.2 kg, postconceptional age 34 + 2 wk. Twelve infants had apnea and 10 exhibited periodic breathing. During sleep the pharyngeal phase of swallowing was detected by a catheter in the pharynx and esophageal peristalsis by an esophageal pressure catheter. Nasal airflow was monitored by a pneumotachometer. During apnea, the frequency of swallows was significantly greater than during the respiratory pauses of periodic breathing (15.9 t 8.2 versus 0.72 -t 0.73 swallows/min, respectively, p < 0.0001) and also much higher than the rate of spontaneous swallows during sleep in either group (0.66 + 0.66 and 0.58 + 1.08 swallows/min, respectively). We conclude that an increased rate of swallowing is characteristic of apnea in premature infants, and distinguishes apnea from the respiratory pauses of periodic breathing. (Pediatr Res 37: 796-799, 1995)

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Section: Methodsmentioning

confidence: 99%

A Comparison of Swallowing During Apnea and Periodic Breathing in Premature Infants

Miller

DiFiore

1995

Pediatr Res

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“…23 Humidified high-flow nasal cannula or nasal intermittent positive-pressure ventilation may be acceptable substitutes for NCPAP. However, larger studies that specifically examine the advantages and disadvantages of nasal intermittent positive-pressure ventilation and high-flow nasal cannula versus conventional NCPAP on the incidence and severity of recurrent apnea are needed.…”

Section: Nasal Continuous Positive Airway Pressurementioning

confidence: 99%

Apnea of Prematurity

2016

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Apnea of prematurity is one of the most common diagnoses in the NICU. Despite the frequency of apnea of prematurity, it is unknown whether recurrent apnea, bradycardia, and hypoxemia in preterm infants are harmful. Research into the development of respiratory control in immature animals and preterm infants has facilitated our understanding of the pathogenesis and treatment of apnea of prematurity. However, the lack of consistent defi nitions, monitoring practices, and consensus about clinical signifi cance leads to signifi cant variation in practice. The purpose of this clinical report is to review the evidence basis for the defi nition, epidemiology, and treatment of apnea of prematurity as well as discharge recommendations for preterm infants diagnosed with recurrent apneic events.

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“…90 This is especially true when these episodes have an element of airway obstruction but it is not effective in central apnea. 91 This is the basis to suggest that the primary effect of CPAP is on airway patency or its splinting effect. However, CPAP has other effects as well.…”

Section: Cpap and Airway Patencymentioning

confidence: 99%

Apnea of prematurity: pathogenesis and management strategies

Mathew

2010

J Perinatol

110

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Apnea of prematurity (AOP) is a significant clinical problem manifested by an unstable respiratory rhythm reflecting the immaturity of respiratory control systems. This review will address the pathogenesis of and treatment strategies for AOP. Although the neuronal mechanisms leading to apnea are still not well understood, recent decades have provided better insight into the generation of the respiratory rhythm and its modulation in the neonate. Ventilatory responses to hypoxia and hypercarbia are impaired and inhibitory reflexes are exaggerated in the neonate. These unique vulnerabilities predispose the neonate to the development of apnea. Treatment strategies attempt to stabilize the respiratory rhythm. Caffeine remains the primary pharmacological treatment modality and is presumed to work through blockade of adenosine receptors A 1 and A 2 . Recent evidences suggest that A 2A receptors may have a greater role than previously thought. AOP typically resolves with maturation suggesting increased myelination of the brainstem.

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Continuous positive airway pressure selectively reduces obstructive apnea in preterm infants

Cited by 168 publications

References 23 publications

A Comparison of Swallowing During Apnea and Periodic Breathing in Premature Infants

A Comparison of Swallowing During Apnea and Periodic Breathing in Premature Infants

Apnea of Prematurity

Apnea of prematurity: pathogenesis and management strategies

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