Apnea of Prematurity - Associates in Newborn Medicine

UNDERSTANDINGApnea of PrematurityAWhat is apnea of prematurity?With apnea [ap-knee-uh], breathing stops temporarilyand then returns to normal. Apnea of prematurityrefers to short periods of time when a prematurebaby stops breathing.BrainWhat causes apnea of prematurity?There are two main causes of apneaof prematurity:• Brain development may not be completeAlveoli(air sac)Inhaled airTracheaLung• The muscles needed for breathingmay be weakOther problems can contribute toapnea, including:• Low red blood cell count (anemia)• Feeding problems– Reflux (stomach contents back upinto throat)– Lack of coordination (baby has troublebreathing while eating)• Heart or lung problems• Infection• Baby is not getting enough oxygen while breathing• Overstimulation• Problems keeping body temperature constantWith apnea, breathing stops fora short period of timeHow will I know if my baby has apnea of prematurity?Most premature babies have apnea. While in the NICU, the baby is hooked up to monitorsthat measure breathing and heart rate. The health care team will tell you if your baby hasperiods of apnea.It is important to manage apnea while it is happening. Otherwise, the baby may not get enoughoxygen. The baby's heart rate also may slow down (bradycardia) during apnea.

Treating Apnea of PrematurityWhat treatment will my baby receive?Treatment depends on how often the baby stops breathingand for how long.• In general, healthy babies with a few periods of apneaper day often do not need treatment.– Gently touching the baby during periods of apnea canhelp get breathing back to normal.– Changing the baby’s position or feeding the baby moreslowly also may help.• Babies who have more frequent apnea may needtreatment to help them breathe.– Medicines like caffeine may be used.– Extra oxygen or air may be delivered using a smalltube in the nose.– In a few cases, the health care team may help thebaby’s breathing by using a mask and a bag or abreathing machine. This machine might be a CPAPor a ventilator.What will happen next?Many babies respond well to treatment for apnea ofprematurity; however, each baby is different. Talk to yourbaby's health care team. They can answer any questionsyou have about your baby.GlossaryAlveoli – tiny sacs in the lungsthat move oxygen from the airinto the bloodAnemia – low red blood cell countApnea – breathing stops for ashort period of timeBradycardia – decreasedheart rateCPAP (continuous positiveairway pressure) – a treatmentthat uses mild pressurized airto keep the lungs openReflux – stomach contents backup into throatSaturation – the amount ofoxygen in the blood. This isexpressed as a percentage ofthe total amount of oxygen thatthe blood can holdTrachea – windpipeVentilator – a machine that helpsthe baby breathe by moving air inand out of the lungsAsk the health care team whenyou have questions—they arethere to help.NOTES:______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Signature: __________________________________________ Date:__________________ Time: ____________ © 2011 Ikaria, Inc. IMK111-01433 September 2011