pediatrics
Apnea of Prematurity
Key Points
Apnea of prematurity is caused by immaturity of neurologic and/or mechanical function of the respiratory system. Until mature, preterm infants may have respiratory pauses>20 seconds or pauses<20 seconds combined with bradycardia (<100 beats/minute) and/or oxygen saturation<85%. Diagnose by observation and exclude other, more serious causes of apnea (eg, infectious, metabolic, thermoregulatory, respiratory, cardiac, or central nervous system disorders). Monitor respiration and give physical stimulation for apnea; if breathing does not resume, give bag-valve-mask ventilation. Give oralcaffeineto neonates who have recurrent episodes. Treatment for gastroesophageal reflux disease should not be started as an intervention for apnea of prematurity. Few infants are discharged with an apnea monitor, and only those whose episodes resolve spontaneously and without stimulation should even be considered for discharge with a monitor. 