ALTE,. APNEA,. and SIDS. Valerie Vickers RNC Apnea Program Coordinator UMC. APNEA is a nonspecific indicator of distress. Failure of a system Early indicator of deterioration. Many known causes of apnea can be diagnosed and treated. Thought to be benign PB Apnea SIDS???.
Many known causes of apnea can be diagnosed and treated.
Apnea and periodic breathing are common in premature infants after the first 24 to 48 hours of life.
Premature infants sleep 80% of the time, term infants 50%. Apnea only occurs with active sleep.
Mixed apnea occurs frequently in premature infants due to:
Apnea > 20 seconds with cyanosis, abrupt, marked pallor or hypotonia, or bradycardia < 100 bpm
AOP is probably caused by abnormality in the central control for breathing:
Decreased inspiratory effort and blunted response to CO2 and O2 plus prolonged brainstem conduction times result in hypoventilation and hypercarbia
May see hypoventilation, apnea or respiratory arrest
Along with fluttering eyelids, drooling or sucking, tonic posturing
“APPARENT LIFE THREATENING EVENT”
(therapeutic range 6-12 mcg/ml)
NOTE: Neither drug has had controlled study for efficacy
Goal is to discharge without methylxanthines or monitor
At Risk Group:
MONITORING CANNOT GUARANTEE SURVIVAL
Parents are the best monitor; use only when the baby is not observed.
Sudden death of any infant or young child which is unexplained by history and in which a thorough post mortem fails to demonstrate and adequate cause of death.*
*Definition taken from the NIH Consensus Development Conference on Infantile Apnea and Home Monitoring
Research indicates that SIDS is more complex than a single abnormality in a single system.