Flashcards in Neonatal Apnoea and SIDS Deck (12)
What factors influence breathing?
Influences from higher centres
Arterial and central chemoreceptors
Lung, airway, CV, muscle and joint reflexes
Where is the respiratory pattern generator?
Reticular formation of the medulla
20seconds or less if associated with cyanosis or bradycardia
Inverse correlation between freq apnoea and gestational age
What are the 3 types of apnoea?
1 - central
2 - obstructive = breathing effort continues but with no airflow
3 - mixed
What is the mechanism of central apnoea?
Immaturity in the chemoreceptor, mechanoreceptor or cerebral cortex pathway which feed in to the pre-Botzinger complex
Chemoreceptors show a reduced response in infants.
Mechanoreceptors (HB Reflex) depressed in prematurity
What is obstructive apnoea?
Site tends to be at laryngeal level as shown by bronchoscopy
? due to hypoxia or asynchrony of respiratory muscles (alae nasi and diaphragm)
Factors involved in apnoea?
Sleep state (> REM)
Rx of apnoea?
Compete with adenosine? Reduce release of GABA
Change environmental temperature
Do apnoeas matter?
Redistribution of blood away from guts and kidney
Fall in anterior cerebral blood flow velocities during the apnoea
What is SIDS?
The sudden death of an infant under one year of age which remains unexplained after a thorough case investigation including a complete autopsy, examination of death scene and review of clinical history.
Risk factors for SIDS
Prone and side sleeping
Soft bedding and soft surfaces
Warmer room temps