Document Detail


Interventions for apnoea of prematurity: a personal view.
MedLine Citation:
PMID:  19958303     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To review treatments for apnoea of prematurity (AOP). METHODS: Literature Review and description of personal practice. RESULTS: Provided that symptomatic apnoea has been ruled out, interventions to improve AOP can be viewed as directed at one of three underlying mechanisms: (i) a reduced work of breathing [e.g. prone positioning, nasal continuous positive airway pressure (CPAP)], (ii) an increased respiratory drive (e.g. caffeine), and (iii) an improved diaphragmatic function (e.g. branched-chain amino acids). Most options currently applied, however, have not yet been shown to be effective and/or safe, except for prone, head-elevated positioning, synchronized nasal ventilation/CPAP, and caffeine. CONCLUSION: Treatment usually follows an incremental approach, starting with positioning, followed by caffeine (which should be started early, at least in infants <1250 g), and nasal ventilation or CPAP via variable flow systems that reduce work of breathing. From a research point of view, we most urgently need data on the frequency and severity of bradycardia and intermittent hypoxia that can yet be tolerated without putting an infant at risk of impaired development or retinopathy of prematurity.
Authors:
C F Poets
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Publication Detail:
Type:  Journal Article; Review     Date:  2009-11-30
Journal Detail:
Title:  Acta paediatrica (Oslo, Norway : 1992)     Volume:  99     ISSN:  1651-2227     ISO Abbreviation:  Acta Paediatr.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-31     Completed Date:  2010-04-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9205968     Medline TA:  Acta Paediatr     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  172-7     Citation Subset:  IM    
Affiliation:
Department of Neonatology, T?bingen University Hospital, T?bingen, Germany. Christian-f.poets@med.uni-tuebingen.de
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MeSH Terms
Descriptor/Qualifier:
Amino Acids / administration & dosage
Apnea / therapy*
Caffeine / therapeutic use
Continuous Positive Airway Pressure
Humans
Infant, Newborn
Infant, Premature
Infant, Premature, Diseases / therapy*
Oxygen Inhalation Therapy
Posture
Chemical
Reg. No./Substance:
0/Amino Acids; 58-08-2/Caffeine

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