Hi, this is Tom, and in this episode I'm going to be going to be going through

apnea of prematureity. And you can find notes at zero to finals.com slash apnea and in the

zero to finals pediatrics book. And you can find flashcards and questions at members.0.0.5.com. So let's jump straight in.

Apnea in neonates is defined as periods where breathing stops spontaneously for more than 20 seconds,

or shorter periods where it's associated with oxygen desaturation,

with an oxygen saturation less than 90%, or bradycardia with a heart rate less than 100.

Apnea can occur in neonates of all gestational ages.

They're often accompanied by a period of bradicardia or a slow heart rate.

Apnea is very common in premature neonates.

The incidence decreases with increased gestational age, so the later the baby is born, the less likely they are to have apnea.

They occur in almost all neonates born less than 28 weeks gestation.

In term infants, they usually indicate underlying pathology. Let's talk about

the causes. Apnea occurs due to immaturity of the autonomic nervous system that controls

respiration and heart rate.

Apnea may indicate an underlying illness such as infection, anemia,

airway obstruction, which may be positional,

central nervous system pathology, for example, intraventricular hemorrhage or seizures, gastroasophageal reflux,

neonatal abstinence syndrome due to maternal substance use, or hypoglycemia.

Finally, let's talk about management. Neonatal units use apnea monitors, which make a sound

when an apnea occurs in an infant. Tactile stimulation, meaning handling the baby, is used to

prompt the baby to restart breathing during an apnea episode.

Intravenous caffeine citrate can be used to prevent apnea and bradycardia in babies who are having

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