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Romero, H., & López, S. (2014). Apnea del recién nacido pretérmino. Revista Repertorio De Medicina Y Cirugía, 23(4), 247-252. https://doi.org/10.31260/RepertMedCir.v23.n4.2014.693
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La apnea del recién nacido pretérmino es una condición con alto riesgo de morbimortalidad es este grupo etario, es por ello que pediatras, neonatólogos, enfermeras, terapeutas y personal en general quienes identifican y de una u otra manera intervienen en la prevención y manejo de esta patología, se ven en la necesidad de permanecer en continua actualización. Se hace una revisión de la literatura acerca de la definición, diagnóstico y tratamiento actual que se puede y debe ofrecer al recién nacido pretérmino con apnea. Abreviaturas: RN, recién nacido; APNP, apnea del neonato prematuro.
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Derechos de autor Fundación Universitaria de Ciencias de la Salud FUCS
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1. Zuñiga M. Informe del evento de mortalidad perinatal y neonatal tardia, hasta el periodo epídemiologico 12 del año 2012. Bogotá: Instituto Nacional de Salud; 2012.
2. Zhao J, Gonzalez F, Mu D. Apnea of prematurity: from cause to treatment. Eur J Pediatr. 2011 Sep;170(9):1097-105.
3. Robertson CM, Watt MJ, Dinu IA. Outcomes for the extremely premature infant: what is new? And where are we going?. Pediatr Neurol. 2009;40(3):189-96.
4. Stokowski LA. A primer on Apnea of prematurity. Adv Neonatal Care. 2005;5(3):155-70
5. Poets CF. Apnea of prematurity: What can observational studies tell us about pathophysiology?. Sleep Med. 2010;11(7):701-7.
6. Mathew OP. Apnea of prematurity: pathogenesis and management strategies. J Perinatol. 2011;31(5):302-10.
7. Martin RJ, Abu-Shaweesh JM, Baird TM. Pathophysiologic mechanisms underlying apnea of prematurity. NeoReviews. 2002;3(4):e59-e65.
8. Darnall RA. The role of CO(2) and central chemoreception in the control of breathing in the fetus and the neonate. Respir Physiol Neurobiol. 2010;173(3):201-12.
9. Baird TM. Clinical correlates, natural history and outcome of neonatal apnoea. Semin Neonatol. 2004;9(3):205-11.
10. Mercer JS, Erickson-Owens DA, Graves B, Haley MM. Evidence-based practices for the fetal to newborn transition. J Midwifery Womens Health. 2007;52(3):262-72.
11. Vento M, Asensi M, Sastre J, Lloret A, Garcia-Sala F, Vina J. Oxidative stress in asphyxiated term infants resuscitated with 100% oxygen. J Pediatr. 2003;142(3):240-6.
12. Gauda EB, McLemore GL, Tolosa J, Marston-Nelson J, Kwak D. Maturation of peripheral arterial chemoreceptors in relation to neonatal apnoea. Semin Neonatol. 2004;9(3):181-94.
13. Cardot V, Chardon K, Tourneux P, Micallef S, Stephan E, Leke A, et al. Ventilatory response to a hyperoxic test is related to the frequency of short apneic episodes in late preterm neonates. Pediatr Res. 2007;62(5):591-6.
14. Khan A, Qurashi M, Kwiatkowski K, Cates D, Rigatto H. Measurement of the CO2 apneic threshold in newborn infants: possible relevance for periodic breathing and apnea. J Appl Physiol. 2005; 98(4):1171-6.
15. Carlo WA, Martin RJ, Difiore JM. Differences in CO2 threshold of respiratory muscles in preterm infants. J Appl Physiol. 1988;65(6):2434-9.
16. Praud JP. Upper airway reflexes in response to gastric reflux. Paediatr Respir Rev. 2010;11(4):208-12.
17. Kelly BN, Huckabee ML, Jones RD, Frampton CM. Nutritive and non-nutritive swallowing apnea duration in term infants: implications for neural control mechanisms. Respir Physiol Neurobiol. 2006;154(3):372-8.
18. Martin RJ, Abu-Shaweesh JM, Baird TM. Apnoea of prematurity. Paediatr Respir Rev. 2004;5 Suppl A:S377-82.
19. Dreshaj IA, Haxhiu MA, Martin RJ. Role of the medullary raphe nuclei in the respiratory response to CO2. Respir Physiol. 1998;111(1):15-23.
20. Bloch-Salisbury E, Hall MH, Sharma P, Boyd T, Bednarek F, Paydarfar D. Heritability of apnea of prematurity: a retrospective twin study. Pediatrics. 2010;126(4):e779-87.
21. Lehtonen L, Martin RJ. Ontogeny of sleep and awake states in relation to breathing in preterm infants. Semin Neonatol. 2004;9(3):229-38.
22. Gerhardt T, Bancalari E. Apnea of prematurity: I. Lung function and regulation of breathing. Pediatrics. 1984;74(1):58-62.
23. Kamaluddeen M, Lodha A, Akierman A. Non-Rotavirus infection causing apnea in a neonate. Indian J Pediatr. 2009;76(10):1051-2.
24. Tourneux P, Cardot V, Museux N, Chardon K, Leke A, Telliez F, et al. Influence of thermal drive on central sleep apnea in the preterm neonate. Sleep. 2008;31(4):549-56.
25. Naik-Mathuria B, Chang S, Fitch ME, Westhoff J, Brandt ML, Ayres NA, et al. Patent ductus arteriosus ligation in neonates: preoperative predictors of poor postoperative outcomes. J Pediatr Surg. 2008;43(6):1100-5.
26. Tipnis NA, Tipnis SM. Controversies in the treatment of gastroesophageal reflux disease in preterm infants. Clin Perinatol. 2009;36(1):153-64.
27. Vialet R, Nau A. Effect of head posture on pediatric oropharyngeal structures: implications for airway management in infants and children. Curr Opin Anaesthesiol. 2009;22(3):396-9.
28. Thompson AM, Bizzarro MJ. Necrotizing enterocolitis in newborns: pathogenesis, prevention and management. Drugs. 2008;68(9):1227-38.
29. Eichenwald EC, Zupancic JA, Mao WY, Richardson DK, McCormick MC, Escobar GJ. Variation in diagnosis of apnea in moderately preterm infants predicts length of stay. Pediatrics. 2011;127(1):e53-8.
30. Eichenwald EC, Aina A, Stark AR. Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks. Pediatrics. 1997;100(3 Pt 1):354-9.
31. Hofstetter AO, Legnevall L, Herlenius E, Katz-Salamon M. Cardiorespiratory development in extremely preterm infants: vulnerability to infection and persistence of events beyond term-equivalent age. Acta Paediatr. 2008;97(3):285-92.
32. Ramanathan R, Corwin MJ, Hunt CE, Lister G, Tinsley LR, Baird T, et al. Cardiorespiratory events recorded on home monitors: Comparison of healthy infants with those at increased risk for SIDS. JAMA. 2001;285(17):2199-207.
33. Baquero Latorre H. Apnea de la prematurez. PRECOP. 2006;5(1):27-37.
34. Di Fiore JM, Arko MK, Miller MJ, Krauss A, Betkerur A, Zadell A, et al. Cardiorespiratory events in preterm infants referred for apnea monitoring studies. Pediatrics. 2001;108(6):1304-8.
35. Di Fiore JM, Walsh M, Wrage L, Rich W, Finer N, Carlo WA, et al. Low oxygen saturation target range is associated with increased incidence of intermittent hypoxemia. J Pediatr. 2012;161(6):1047-52.
36. Di Fiore JM, Bloom JN, Orge F, Schutt A, Schluchter M, Cheruvu VK, et al. A higher incidence of intermittent hypoxemic episodes is associated with severe retinopathy of prematurity. J Pediatr. 2010;157(1):69-73.
37. Osborn DA, Henderson-Smart DJ. Kinesthetic stimulation for treating apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000499.
38. Henderson-Smart DJ, Osborn DA. Kinesthetic stimulation for preventing apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000373.
39. Changing concepts of sudden infant death syndrome: implications for infant sleeping environment and sleep position. American Academy of Pediatrics. Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. Pediatrics. 2000;105(3 Pt 1):650-6.
40. Jeffery HE, Megevand A, Page H. Why the prone position is a risk factor for sudden infant death syndrome. Pediatrics. 1999;104(2 Pt 1):263-9.
41. Keene DJ, Wimmer JE, Jr., Mathew OP. Does supine positioning increase apnea, bradycardia, and desaturation in preterm infants?. J Perinatol. 2000;20(1):17-20.
42. Henderson-Smart DJ, Steer P. Methylxanthine treatment for apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000140.
43. Comer AM, Perry CM, Figgitt DP. Caffeine citrate: a review of its use in apnoea of prematurity. Paediatr drugs. 2001;3(1):61-79.
44. Erenberg A, Leff RD, Haack DG, Mosdell KW, Hicks GM, Wynne BA. Caffeine citrate for the treatment of apnea of prematurity: a double-blind, placebo-controlled study. Pharmacotherapy. 2000;20(6):644-52.
45. Steer PA, Henderson-Smart DJ. Caffeine versus theophylline for apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000273.
46. American Academy of Pediatrics Committee on Drugs: Precautions concerning the use of theophylline. Pediatrics. 1992;89(4 Pt 2):781-3.
47. Hospital Británico. Departamento de Pediatría. Unidad Neonatal. Apnea del prematuro. Archiv Pediatr Urug. 2007;78:54-7.
48. Zagol K, Lake DE, Vergales B, Moorman ME, Paget-Brown A, Lee H, et al. Anemia, apnea of prematurity, and blood transfusions. J Pediatr. 2012;161(3):417-21 e1.
49. Lorch SA, Srinivasan L, Escobar GJ. Epidemiology of apnea and bradycardia resolution in premature infants. Pediatrics. 2011;128(2):e366-73.
50. American Academy of Pediatrics. Committee on Fetus and Newborn. Apnea, sudden infant death syndrome, and home monitoring. Pediatrics. 2003;111(4 Pt 1):914-7.
2. Zhao J, Gonzalez F, Mu D. Apnea of prematurity: from cause to treatment. Eur J Pediatr. 2011 Sep;170(9):1097-105.
3. Robertson CM, Watt MJ, Dinu IA. Outcomes for the extremely premature infant: what is new? And where are we going?. Pediatr Neurol. 2009;40(3):189-96.
4. Stokowski LA. A primer on Apnea of prematurity. Adv Neonatal Care. 2005;5(3):155-70
5. Poets CF. Apnea of prematurity: What can observational studies tell us about pathophysiology?. Sleep Med. 2010;11(7):701-7.
6. Mathew OP. Apnea of prematurity: pathogenesis and management strategies. J Perinatol. 2011;31(5):302-10.
7. Martin RJ, Abu-Shaweesh JM, Baird TM. Pathophysiologic mechanisms underlying apnea of prematurity. NeoReviews. 2002;3(4):e59-e65.
8. Darnall RA. The role of CO(2) and central chemoreception in the control of breathing in the fetus and the neonate. Respir Physiol Neurobiol. 2010;173(3):201-12.
9. Baird TM. Clinical correlates, natural history and outcome of neonatal apnoea. Semin Neonatol. 2004;9(3):205-11.
10. Mercer JS, Erickson-Owens DA, Graves B, Haley MM. Evidence-based practices for the fetal to newborn transition. J Midwifery Womens Health. 2007;52(3):262-72.
11. Vento M, Asensi M, Sastre J, Lloret A, Garcia-Sala F, Vina J. Oxidative stress in asphyxiated term infants resuscitated with 100% oxygen. J Pediatr. 2003;142(3):240-6.
12. Gauda EB, McLemore GL, Tolosa J, Marston-Nelson J, Kwak D. Maturation of peripheral arterial chemoreceptors in relation to neonatal apnoea. Semin Neonatol. 2004;9(3):181-94.
13. Cardot V, Chardon K, Tourneux P, Micallef S, Stephan E, Leke A, et al. Ventilatory response to a hyperoxic test is related to the frequency of short apneic episodes in late preterm neonates. Pediatr Res. 2007;62(5):591-6.
14. Khan A, Qurashi M, Kwiatkowski K, Cates D, Rigatto H. Measurement of the CO2 apneic threshold in newborn infants: possible relevance for periodic breathing and apnea. J Appl Physiol. 2005; 98(4):1171-6.
15. Carlo WA, Martin RJ, Difiore JM. Differences in CO2 threshold of respiratory muscles in preterm infants. J Appl Physiol. 1988;65(6):2434-9.
16. Praud JP. Upper airway reflexes in response to gastric reflux. Paediatr Respir Rev. 2010;11(4):208-12.
17. Kelly BN, Huckabee ML, Jones RD, Frampton CM. Nutritive and non-nutritive swallowing apnea duration in term infants: implications for neural control mechanisms. Respir Physiol Neurobiol. 2006;154(3):372-8.
18. Martin RJ, Abu-Shaweesh JM, Baird TM. Apnoea of prematurity. Paediatr Respir Rev. 2004;5 Suppl A:S377-82.
19. Dreshaj IA, Haxhiu MA, Martin RJ. Role of the medullary raphe nuclei in the respiratory response to CO2. Respir Physiol. 1998;111(1):15-23.
20. Bloch-Salisbury E, Hall MH, Sharma P, Boyd T, Bednarek F, Paydarfar D. Heritability of apnea of prematurity: a retrospective twin study. Pediatrics. 2010;126(4):e779-87.
21. Lehtonen L, Martin RJ. Ontogeny of sleep and awake states in relation to breathing in preterm infants. Semin Neonatol. 2004;9(3):229-38.
22. Gerhardt T, Bancalari E. Apnea of prematurity: I. Lung function and regulation of breathing. Pediatrics. 1984;74(1):58-62.
23. Kamaluddeen M, Lodha A, Akierman A. Non-Rotavirus infection causing apnea in a neonate. Indian J Pediatr. 2009;76(10):1051-2.
24. Tourneux P, Cardot V, Museux N, Chardon K, Leke A, Telliez F, et al. Influence of thermal drive on central sleep apnea in the preterm neonate. Sleep. 2008;31(4):549-56.
25. Naik-Mathuria B, Chang S, Fitch ME, Westhoff J, Brandt ML, Ayres NA, et al. Patent ductus arteriosus ligation in neonates: preoperative predictors of poor postoperative outcomes. J Pediatr Surg. 2008;43(6):1100-5.
26. Tipnis NA, Tipnis SM. Controversies in the treatment of gastroesophageal reflux disease in preterm infants. Clin Perinatol. 2009;36(1):153-64.
27. Vialet R, Nau A. Effect of head posture on pediatric oropharyngeal structures: implications for airway management in infants and children. Curr Opin Anaesthesiol. 2009;22(3):396-9.
28. Thompson AM, Bizzarro MJ. Necrotizing enterocolitis in newborns: pathogenesis, prevention and management. Drugs. 2008;68(9):1227-38.
29. Eichenwald EC, Zupancic JA, Mao WY, Richardson DK, McCormick MC, Escobar GJ. Variation in diagnosis of apnea in moderately preterm infants predicts length of stay. Pediatrics. 2011;127(1):e53-8.
30. Eichenwald EC, Aina A, Stark AR. Apnea frequently persists beyond term gestation in infants delivered at 24 to 28 weeks. Pediatrics. 1997;100(3 Pt 1):354-9.
31. Hofstetter AO, Legnevall L, Herlenius E, Katz-Salamon M. Cardiorespiratory development in extremely preterm infants: vulnerability to infection and persistence of events beyond term-equivalent age. Acta Paediatr. 2008;97(3):285-92.
32. Ramanathan R, Corwin MJ, Hunt CE, Lister G, Tinsley LR, Baird T, et al. Cardiorespiratory events recorded on home monitors: Comparison of healthy infants with those at increased risk for SIDS. JAMA. 2001;285(17):2199-207.
33. Baquero Latorre H. Apnea de la prematurez. PRECOP. 2006;5(1):27-37.
34. Di Fiore JM, Arko MK, Miller MJ, Krauss A, Betkerur A, Zadell A, et al. Cardiorespiratory events in preterm infants referred for apnea monitoring studies. Pediatrics. 2001;108(6):1304-8.
35. Di Fiore JM, Walsh M, Wrage L, Rich W, Finer N, Carlo WA, et al. Low oxygen saturation target range is associated with increased incidence of intermittent hypoxemia. J Pediatr. 2012;161(6):1047-52.
36. Di Fiore JM, Bloom JN, Orge F, Schutt A, Schluchter M, Cheruvu VK, et al. A higher incidence of intermittent hypoxemic episodes is associated with severe retinopathy of prematurity. J Pediatr. 2010;157(1):69-73.
37. Osborn DA, Henderson-Smart DJ. Kinesthetic stimulation for treating apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000499.
38. Henderson-Smart DJ, Osborn DA. Kinesthetic stimulation for preventing apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000373.
39. Changing concepts of sudden infant death syndrome: implications for infant sleeping environment and sleep position. American Academy of Pediatrics. Task Force on Infant Sleep Position and Sudden Infant Death Syndrome. Pediatrics. 2000;105(3 Pt 1):650-6.
40. Jeffery HE, Megevand A, Page H. Why the prone position is a risk factor for sudden infant death syndrome. Pediatrics. 1999;104(2 Pt 1):263-9.
41. Keene DJ, Wimmer JE, Jr., Mathew OP. Does supine positioning increase apnea, bradycardia, and desaturation in preterm infants?. J Perinatol. 2000;20(1):17-20.
42. Henderson-Smart DJ, Steer P. Methylxanthine treatment for apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000140.
43. Comer AM, Perry CM, Figgitt DP. Caffeine citrate: a review of its use in apnoea of prematurity. Paediatr drugs. 2001;3(1):61-79.
44. Erenberg A, Leff RD, Haack DG, Mosdell KW, Hicks GM, Wynne BA. Caffeine citrate for the treatment of apnea of prematurity: a double-blind, placebo-controlled study. Pharmacotherapy. 2000;20(6):644-52.
45. Steer PA, Henderson-Smart DJ. Caffeine versus theophylline for apnea in preterm infants. Cochrane Database Syst Rev. 2000(2):CD000273.
46. American Academy of Pediatrics Committee on Drugs: Precautions concerning the use of theophylline. Pediatrics. 1992;89(4 Pt 2):781-3.
47. Hospital Británico. Departamento de Pediatría. Unidad Neonatal. Apnea del prematuro. Archiv Pediatr Urug. 2007;78:54-7.
48. Zagol K, Lake DE, Vergales B, Moorman ME, Paget-Brown A, Lee H, et al. Anemia, apnea of prematurity, and blood transfusions. J Pediatr. 2012;161(3):417-21 e1.
49. Lorch SA, Srinivasan L, Escobar GJ. Epidemiology of apnea and bradycardia resolution in premature infants. Pediatrics. 2011;128(2):e366-73.
50. American Academy of Pediatrics. Committee on Fetus and Newborn. Apnea, sudden infant death syndrome, and home monitoring. Pediatrics. 2003;111(4 Pt 1):914-7.
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