apnea of prematurity
Recently Published Documents


TOTAL DOCUMENTS

306
(FIVE YEARS 52)

H-INDEX

32
(FIVE YEARS 2)

2021 ◽  
Author(s):  
Alison Protain ◽  
Kimberly Firestone ◽  
Saima Hussain ◽  
Daniel Lubarsky ◽  
Howard Stein

Abstract Neonates with apnea of prematurity (AOP) deteriorate clinically because CPAP often provides inadequate support during apnea. NAVA provides proportional ventilator support from the electrical activity of the diaphragm. When NAVA level is 0 cmH20/mcV (NN0), patients receive minimal support when breathing and backup ventilation when apneic. This study addresses feasibility of NN0 and time spent in back up ventilation. This was a prospective, two center, observational study of preterm neonates on NN0 for AOP. Ventilator data were downloaded for 24 hours. Number of Clinically Significant Events (CSEs) and switches to back up were collected. Statistics were paired t-test. There were twenty-eight subjects with gestational age of 25 + 1.8 weeks; study age 28 ± 23 days. Number of events were 4±4.39 per 24 hours. Subjects were on NN0 approximately 90% each minute, back-up mode 2.5±1.1 times/minute with 10.6±7.2% in back-up. Conclusion: Preterm neonates on NAVA level 0 had few clinically significant events with minimal time in back up ventilation.


Author(s):  
Kamran Ali Shahani ◽  
Feriha Fatima Khidri ◽  
Hina Riaz ◽  
Komal Siddiqui ◽  
Keenjhar Rani ◽  
...  

Objective: To identify and determine the frequency of complications in neonates with low birth weight. Methodology: This cross sectional study was conducted at Khairpur Medical College and Lady Willingdon Hospital, Khairpur Mirs from January 2018 to July 2021. Two hundred (n=200) neonates with low birth weight (<2500 grams) were recruited and frequency of different complications were observed. Results: The mean age of the neonates was 10.50 ± 4.34 days. Of the 200 neonates with low birth weight, 132 neonates (66%) presented with various complications; however 68 neonates (34%) were normal and without complications. Of the 200 neonates with low birth weight, the following complications were observed, hypoglycaemia (14.5%), jaundice (12.5%), respiratory distress syndrome (8%), feeding problems (8%), congenital cardiac defects (5%), hypothermia (4%), other complications such as sepsis (2%), apnea of prematurity (2%), intraventricular haemorrhage (2%), and more than 1 complications (16 neonates, 8%). Conclusions: In conclusion, hypoglycaemia and jaundice were the common complications associated with low birth weight in neonates. Advanced maternal age during childbirth, stress, lower socioeconomic conditions, consanguineous marriages, lower body mass index and maternal illness such as preeclampsia and anaemia were the risk factors of low birth weight observed in our study. Risk factors may be identified earlier in order to lessen the morbidities and mortality in low birth weight neonates.


Author(s):  
Corine Bürgin ◽  
Patrizia Simmen ◽  
Nishant Gupta ◽  
Lilian Suter ◽  
Samuel Kreuzer ◽  
...  

Abstract Background Apnea of prematurity cannot be reliably measured with current monitoring techniques. Instead, indirect parameters such as oxygen desaturation or bradycardia are captured. We propose a Kalman filter-based detection of respiration activity and hence apnea using multichannel esophageal signals in neonatal intensive care unit patients. Methods We performed a single-center observational study with moderately preterm infants. Commercially available nasogastric feeding tubes containing multiple electrodes were used to capture signals with customized software. Multichannel esophageal raw signals were manually annotated, processed using extended Kalman filter, and compared with standard monitoring data including chest impedance to measure respiration activity. Results Out of a total of 405.4 h captured signals in 13 infants, 100 episodes of drop in oxygen saturation or heart rate were examined. Median (interquartile range) difference in respiratory rate was 0.04 (−2.45 to 1.48)/min between esophageal measurements annotated manually and with Kalman filter and −3.51 (−7.05 to −1.33)/min when compared to standard monitoring, suggesting an underestimation of respiratory rate when using the latter. Conclusions Kalman filter-based estimation of respiratory activity using multichannel esophageal signals is safe and feasible and results in respiratory rate closer to visual annotation than that derived from chest impedance of standard monitoring.


2021 ◽  
Vol 26 (6) ◽  
pp. 608-614
Author(s):  
Laura A. Salemi ◽  
Anna L. Sahlstrom ◽  
Sin Yin Lim ◽  
Peter N. Johnson ◽  
Douglas Dannaway ◽  
...  

OBJECTIVE Caffeine citrate doses &gt;5 mg/kg/day are frequently used for apnea of prematurity. The primary objective was identification of patients maintained on 5 mg/kg/day (Group 1). Secondary objectives included identification of patients requiring dose increases: 7.5 mg/kg every 24 hours (Group 2), 10 mg/kg every 24 hours (Group 3), and 5 mg/kg every 12 hours (Group 4); comparison of demographics and clinical characteristics; and identification of patients requiring dose adjustments owing to caffeine-associated tachycardia. METHODS Retrospective study of neonates born between 23 to &lt;31 weeks' gestation, receiving caffeine between January 1, 2015, and July 31, 2019. Patients receiving caffeine &lt;1 week, initial maintenance dose &gt;5 mg/kg/day, or with congenital abnormalities were excluded. Descriptive and inferential statistics were performed, with a p &lt; 0.05. RESULTS Overall, 281 patients were included, with 99 (35.2%) in Group 1; 56 (19.9%) in Group 2; 47 (16.7%) in Group 3; and 79 (28.1%) in Group 4. Significant differences in gestational age were noted, with Group 3 and 4 patients being more premature than Groups 1 and 2 (p &lt; 0.001). Dose increases occurred at a median postnatal age and postmenstrual age of 13.0 days and 31.4 weeks in Group 2; 17.0 days and 30.3 weeks in Group 3; and 16.0 days and 30.1 weeks in Group 4. Significant differences were noted for development of tachycardia requiring dose adjustment, with Groups 3 and 4 having the highest percentage (p &lt; 0.001). CONCLUSIONS Two-thirds received caffeine citrate doses &gt;5 mg/kg/day, with 44% receiving 10 mg/kg/day. Further exploration is necessary to determine the optimal PNA or PMA for dose adjustments.


2021 ◽  
Vol 12 ◽  
Author(s):  
Jia-Yi Long ◽  
Hong-Li Guo ◽  
Xin He ◽  
Ya-Hui Hu ◽  
Ying Xia ◽  
...  

Caffeine citrate is the drug of choice for the pharmacological treatment of apnea of prematurity. Factors such as maturity and genetic variation contribute to the interindividual variability in the clinical response to caffeine therapy in preterm infants, making the optimal dose administered controversial. Moreover, the necessity for therapeutic drug monitoring (TDM) of caffeine is still worth discussing due to the need to achieve the desired target concentrations as well as concerns about the safety of higher doses. Therefore, we reviewed the pharmacokinetic profile of caffeine in preterm infants, evidence of the safety and efficacy of different doses of caffeine, therapeutic concentration ranges of caffeine and impact of genetic variability on caffeine therapy. Whereas the safety and efficacy of standard-dose caffeine have been demonstrated, evidence for the safety of higher administered doses is insufficient. Thus, preterm infants who lack clinical response to standard-dose caffeine therapy are of interest for TDM when dose optimization is performed. Polymorphisms in pharmacodynamics-related genes, but not in pharmacokinetics-related genes, have a significant impact on the interindividual variability in clinical response to caffeine therapy. For preterm infants lacking clinical response, how to develop individualized medication regimens for caffeine remains to be explored.


Author(s):  
Chava Rosen ◽  
Camilia Taran ◽  
Marwan Hanna ◽  
Itai Gueta ◽  
Ronen Loebstein ◽  
...  

2021 ◽  
Vol 8 (5) ◽  
pp. 933
Author(s):  
Sriram Pothapregada ◽  
Umamaheswari K. ◽  
Soumya Ram

Apnea of prematurity (AOP) is an extremely common problem in preterm babies. Several invasive and non-invasive methods of treatment have been studied. We present a novel non-invasive method of managing intractable apnea in preterm neonates.


Sign in / Sign up

Export Citation Format

Share Document