Obstructive, mixed, and central apnea in the neonate: Physiologic correlates

doi:10.1016/S0022-3476(05)80349-X

The Journal of Pediatrics

Volume 121, Issue 6, December 1992, Pages 943-950

https://doi.org/10.1016/S0022-3476(05)80349-X Get rights and content

In an attempt to determine physiologic responses to neonatal apnea, we evaluated changes in heart rate and oxygen saturation as measured by pulse oximetry during 2082 episodes of apnea lasting 15 seconds or more in 47 infants less than 34 weeks of gestational age with idiopathic apnea of prematurity. Of these episodes, 832 (39.9%) were central, 1032 (49.6%) were mixed, and 218 (10.5%) were obstructive. Oxygen saturation decreased with increasing duration of apnea regardless of type or treatment, and the decrease in saturation was correlated with preapnea saturation. The baseline heart rate was similar for all apnea types. Infants receiving doxapram had a lower baseline heart rate (137.8±10.5 beats/min) than did infants receiving no therapy (142.8±16.6 beats/min) and infants receiving theophylline (149.7±15.0 beats/min) (p=<0.001). A heart rate fall to less than 100 beats/min was seen more frequently with central apnea than with mixed or obstructive events, and in fants who were not receiving therapy. Falls in heart rate were significantly less in infants receiving doxapram (27.8%±18.0%) than in infants receiving theophylline (44.5%±19.0%) or no therapy (48.4%±18.3%) (p=<0.001). The most common heart rate pattern overall was a gradual decrease interrupted by accelerations, whereas an initial heart rate acceleration was the most common pattern in obstructive apnea. We conclude that heart rate response to neonatal apnea is complex and is dependent on therapy and on type and duration of apnea.

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Obstructive, mixed, and central apnea in the neonate: Physiologic correlates

J Pediatr

Respir Physiol

Respir Physiol

J Pediatr

J Pediatr

Neonatal apnea: diagnosis by nurse versus computer

Pediatrics

An explanation for failure of impedance apnea alarm systems

Arch Dis Child

Undetected episodes of prolonged apnea and severe bradycardia in preterm infants

Apnea monitor failure in infants with upper airway obstruction

Pediatrics

Monitoring for central apnoea in infancy: limitations of single channel recordings

Arch Dis Child

Episodic airway obstruction in premature infants

Am J Dis Child

Statistical methods

Dose-response relationship of doxapram in the therapy for refractory idiopathic apnea of prematurity

Pediatrics

Relation between apnoea duration and type and neurological status of preterm infants

Arch Dis Child