Treatment options for apnoea of prematurity

Abstract

Apnoea of prematurity (AOP) affects almost all infants born at <28 weeks gestation or with birth weight <1000 g. When untreated, AOP may be associated with negative outcomes. Because of these negative outcomes, effective treatment for AOP is an important part of optimising care of preterm infants. Standard treatment usually involves xanthine therapy and respiratory support. Cutting-edge work with stochastic vibrotactile stimulation and new pharmaceutical agents continues to expand therapeutic options. In this article, we review the pathophysiology of AOP, associated conditions and treatment options.

Retrospective study shows that doxapram therapy avoided the need for endotracheal intubation in most premature neonates

“…The first choice pharmacological agents for the treatment of AOP are methylxanthines: caffeine, theophylline or aminophylline . Methylxanthines stimulate the respiratory system, thereby reducing apnoea.…”

Caffeine citrate improves outcomes of apnea of prematurity based on gestational ages

“…AOP is a common and troublesome disorder which requires intervention to avoid potential morbidity in premature infants who need neonatal intensive care (15). The pathogenesis of apnea is due to immaturity of the respiratory control systems characterized by an abnormal ventilatory response to carbon dioxide and hypoxia combined with immature reflex responses (16).…”

Improving Neonatal Care with Technology

“…These issues can be overcome when the tactile stimulation (and/or increasing the oxygen) is applied automatically. Studies have demonstrated that automatic vibrotactile stimulation decreased the occurrence and duration of apneas in preterm infants (15). However, further research is still needed and devices for automatic stimulation are not yet available for clinical use.…”