Emergency treatment for apnea
Infants or children who are unconscious or bluish due to lack of oxygen, an urgent need to give artificial respiration.
Description apnea causes usually in adultssmooth and rhythmic breathing. Newborns often observed violation of the respiratory rhythm, it can be rough, surface, acceleration or deceleration, respiratory arrest may occur.
Under apnoeticheskim gap or apnoeticheskimepisode, the doctors understand the prolonged pause in breathing, accompanied in the most severe cases, a fall of cardiac activity and often cyanosis (a bluish skin, lips, nails, caused by lack of oxygen in the blood). During the breathing reflex suppressed during apnoeticheskogo episode. In mild cases of respiratory pause is short-term (10 to 15 seconds), and the child will automatically start to breathe again. In more severe situations, if no breathing for more than 20 seconds (or even less preterm), the child carbon dioxide accumulates in the blood and oxygen supply is missing, which leads to a resumption of breathing. On the other hand, a child can lose consciousness. Respiratory arrest (apnea) most often occurs during sleep. Actually apnoeticheskie short pauses are normal to have a certain sleep phase novovrozhdennyh as at term and preterm. However, most of the episodes of apnea during normal sleep short of breath, and again automatically restored.
Sleep apnea is characterized by periodic breathing,which develops for various reasons. Periodic breathing is characterized by deep respiratory movements for 10-15 seconds and a pause of 5-10 seconds, and then again ragged deep breathing and again pause. Pauses during periodic breathing is shorter than for apnea. Periodic breathing is most frequently associated with the awakening of the child; This can occur when sucking movements, rapid eye movements. Heart rate is not reduced in the child. Periodic breathing is less common than sleep apnea, and much less dangerous. The tendency to sleep apnea is seen in the two groups of infants. The first group - Premature babies born before 34 weeks of pregnancy. During the first few days of life, most premature babies have a tendency to irregular breathing.
The probability of apnea in preterm infants in ordermore than the smaller the period of gestation of the child and less than the maturity of the central nervous system. In severe prematurity (30 weeks) is very high probability of sleep apnea episodes. Any procedures or conditions causing violation of airway baby, can cause sleep apnea.
Young children receive a limited number ofoxygen. Consequently apnoeticheskie long intervals, such as 30 seconds, may have a more pronounced impact on a small child than a large one.
Apnea is sometimes a consequence of pulmonarydiseases. The most common baby sleep apnea first appears on the first or second day of the life of a premature baby, and observed until the age of full-term baby. By this time in normal preterm (in the absence of other diseases) cases of sleep apnea is usually terminated.
Sometimes children born in 34-42 weekspregnancy, there is a constant apnea, since the age of secondhand weeks and older. This so-called "late apnea" can sometimes be a consequence of serious diseases, such as infections, seizures, congenital heart disease, anemia, meningitis or gastrozzofagalny reflux (stomach contents into the esophagus throw). In the treatment of these diseases or, in extreme cases, in the treatment of sleep apnea aponoe symptoms disappear within 1 year after it began.
Repeated episodes of apnea duringa long time can lead to mental retardation or even life-threatening. Long later observed apnea can lead to a condition requiring resuscitation and threatening the development of the syndrome of sudden infant deaths (SHS).
Premature babies should be inintensive care unit premature. As they grow and develop in special incubators (incubators), their vital functions, including heart rate and respiratory rate, are under constant surveillance. By reducing the heart rate, heart monitor beeps. This signal may, in combination with a bluish tint of the skin and a reduction in body temperature, indicating apnea.
Later apnea often celebrated at home than inhospital. Unfortunately, parents are not always advised of the possibility of sleep apnea in children. They may not notice the temporary pauses in breathing while sleeping child.
Parents usually do not seek immediate medical help until they are caught at the moment of the child's severe episodes of apnea and not notice the pallor or blueness of his skin.
Complications in children with sleep apnea
Complications apneas depend on age of the baby, and the duration of seizure frequency, duration of apnea and its causes.
The reduced amount of oxygen entering thelungs, leading to increased blood and tissue pH (acidosis) and reduction fine arterial branches in the lungs, thereby increasing the blood pressure in the lungs (pulmonary hypertension). Prolonged and excessive use of oxygen in the treatment of sleep apnea can lead to retinopathy of prematurity (eye disease, with the most severe form of which develop complete or partial detachment of the cornea and blindness as a result). The risk of the disease can be reduced by constantly watching the level of oxygen in the baby's blood. Heavy and prolonged apnea leads to brain damage and cerebral palsy later. If your child comes home heavy apnoetichesky episode during sleep and goes unnoticed or ineffective CPR, the child may die.
Apnea Treatment depends on the child's age of the patient, the duration of the existence and duration of apnea and attack its causes, if known.
A child born to the age of 34 weekspregnancy, should be kept under observation in the intensive care unit. If the heart monitor records the fall of heart rate below 100 beats per minute, the alarm sounds. Careful medical intervention, such as a blow baby finger, it is often sufficient to ensure that the child began to breathe again. (Incubator with "water crib" or vibrating incubator can provide long-term, cautious stimulation breath.) Sometimes it takes more vigorous action, such as repetitive irritation stop baby fingers. In severe apnoeticheskih episodes, in particular the duration of 30 to 45 seconds, a child can not respond to the stimulation of touch. In these cases, before the end of the episode apnoeticheskogo use a special resuscitation bag and mask.
If apnea episodes observed more than 2-3 times in an houror there are frequent and severe episodes requiring the use of a bag or mask the need for further treatment. Lowering the temperature in the incubator, the increase in the oxygen supply, the blood transfusion may decrease the frequency of attacks. In rare cases, these measures are ineffective, and the child needed mechanical ventilation.
In cases of late apnea is recommendedpermanent home surveillance until the child finally stop the attacks or not the cause is corrected. Under the constant supervision of the home means constant monitoring of respiratory rate and heart rate. Apnea Treatment possible and folk remedies. In Moscow, there are many clinics that can provide professional help in the treatment of sleep apnea.
The probability of occurrence of apnea to help reducethorough prenatal control, which reduces the possibility of the birth of a premature baby. The effects of sleep apnea will avoid constant supervision of nurses at the hospital for children at-risk for the disease.