The Art and Science of Caring: Focus on the Family: THE LONG ROAD HOMEA PRIMER ON APNEA OF PREMATURITYSTOKOWSKI, LAURA A. RN, MSEditor(s): MENGHINI, KARIN GRACEY RNC, MS, CNNP Author Information Inova Fairfax Hospital for Children, Falls Church, Va. Address reprint requests to Laura A. Stokowski, RN, MS, Inova Fairfax Hosptial for Children, Neonatal Intensive Care Unit, 3300 Gallows Road, Falls Church, Va 22042-3300. E-mail: [email protected] No conflict of interest disclosed. Advances in Neonatal Care: June 2005 - Volume 5 - Issue 3 - p 155-170 doi: 10.1016/j.adnc.2005.02.010 Buy Take the CE Test Metrics Abstract Apnea, the cessation of respiratory airflow, can begin in many preterm infants in the first week of life and can last until the day of discharge or beyond. This article provides an overview of the complex anatomic, physiological, and developmental mechanisms related to immaturity of both the central nervous system and musculature of the pulmonary system, that contribute to apnea of prematurity. Apnea of prematurity is a diagnosis of exclusion; an array of other conditions and stimuli can also cause apnea, including infections, pulmonary disease, and intracranial pathology. The standard clinical management of apnea, including cutaneous stimulation, methylxanthine therapy, and continuous positive airway pressure or ventilatory support, are discussed as well as newer investigational therapies, such as olfactory stimulation. Emerging evidence on the long-term neurodevelopmental impact of apnea is reviewed. Nursing measures to prevent and manage apnea are reviewed with an emphasis on parent education and preparation for discharge. Apnea resolves in most preterm infants as they approach term corrected gestational age; however, if it does not, options include continued hospitalization or, for infants with stable apnea, discharge with a home apnea monitor. © 2005 National Association of Neonatal Nurses
