apnea
TRANSCRIPT
![Page 1: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/1.jpg)
SPECIAL NEONATAL DISORDERS
Presented by,L.SOUNDARYAM.SC.NURSING(PEDIATRICS)
![Page 2: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/2.jpg)
• APNEA• MECONIUM ASPIRATIONS • ATELECTASIS• BRONCHOPNEUMONIA DYSPLASIA• PULMONARY DYSMATURITY• RETROLENTAL FIBROPLASIAS• NECROTISING ENTEROCOLITIS• INTRAVENTRICULAR HAEMORRHAGE• HYPERBILIRUBINEMIA• IRDS
![Page 3: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/3.jpg)
APNEA
• When the cession of respiration is more prolonged than that associated with periodic breathing, usually 10-20 seconds or longer and is followed by color change and bradycardia, the condition is called apnea.
![Page 4: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/4.jpg)
DEFINITION
• Apnea is a "pause in breathing of longer than 10 to 15 seconds, often associated with bradycardia, cyanosis, or both." (Martin et al)..
![Page 5: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/5.jpg)
Etiology• Intracranial hemorrhage• Physiological anemia• Patent ductus arteriosis• Pneumonia or sepsis• Hypoglycemia, hypocalcaemia • Gastrointestinal - NEC or gastro-esophageal reflux• Temperature Regulation - Hypothermia or
hyperthermia • Drugs - (narcotics, beta-blockers). Postnatal
exposure to sedatives, hypnotics or narcotics.
![Page 6: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/6.jpg)
PATHOPHYSIOLOGY1.Central apnea
2.Obstructive apnea
3. Mixed apnea
![Page 7: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/7.jpg)
features
• Bradycardia (below 80-100 beats /minute) appears 30 seconds after cessation of respiration.
• Apnea in premature infants can result in a failure of the mechanisms that protect cerebral blood flow, resulting in ischemia and eventually leukomalacia.
• During apneic episodes, in an attempt to protect cerebral blood flow cardiac output is diverted away from the mesenteric arteries resulting in intestinal ischemia and possibly NECROTIZING ENTEROCOLITIS (NEC).
![Page 8: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/8.jpg)
Nursing Management Close monitoring of the baby• Gentle sensory stimulation-to initiate the
breathing• (Rubbing the back, stroking the face, chest,
and legs.) • suctioning and resucitation• Oro-gastric tube can be inserted – to
decompress the stomach• Bradycardia- continues- mechanical ventilation
is necessary• Primary management is Oxygen therapy
![Page 9: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/9.jpg)
• Theophylline can be given as intravenously.
• When alarm sounds, the nurse must make an immediate effort to stimulate or resuscitate the infant.
• Caffeine has also been found to improve ventilation and to establish more regular breathing pattern through CNS stimulation.
![Page 10: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/10.jpg)
Pharmacotherapy :*caffeine iv Loading dose : 20mg /kg/doseMaintenance dose: 5mg / kg/ day*theophylline: loading dose:6mg/kg/doseMaintenanance dose: 6mg/kg/day iv
![Page 11: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/11.jpg)
![Page 12: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/12.jpg)
• Continuous Positive Airway Pressure (CPAP) - CPAP is effective in treating both obstructive and mixed apnea, but not central apnea.
• CPAP is most commonly delivered by nasal prongs or by an endotracheal tube placed in the nasopharynx.
![Page 13: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/13.jpg)
Problems of apnea
• Hypoxia• Cyanosis• Brain damage• Death
![Page 14: apnea](https://reader036.vdocuments.net/reader036/viewer/2022083116/5889b8501a28aba54d8b697f/html5/thumbnails/14.jpg)
THANK YOU