Doctor explains: What is Apnea of Prematurity? Is it bad?!!

Cause? Treatment? Is CAFFEINE bad for babies??! What other treatments do we use??!! What is an event? How many SECONDS to be considered apnea? What about bradycardia? What CAUSES them? Is all apnea= apnea of prematurity? How do we prevent/ treat events? Do events affect prognosis? Are all events the same? When can we discharge babies HOME? When should we stop caffeine? What are the outcomes of infants who received caffeine?
Learn all this and more in our LONGEST video yet (sorry! there was a lot!)
For the PDF summary of THIS video, (+ 50 free Multiple Choice Questions/ Answers and explanations!!), AND a bunch of other stuff, subscribe to our Neonatal Nuggets Newsletter here:
talatalksnicu....
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Dr. Tala is a board-certified neonatologist and has worked in busy level III and IV units for the past 15 years. She has won multiple teaching awards throughout her time as a neonatologist.
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(Selected) References:
Eichenwald EC; Committee on Fetus and Newborn, American Academy of Pediatrics. Apnea of Prematurity. Pediatrics. 2016 Jan;137(1). doi: 10.1542/peds.2015-3757. Epub 2015 Dec 1. PMID: 26628729.
Schmidt B, Roberts RS, Davis P, Doyle LW, Barrington KJ, Ohlsson A, Solimano A, Tin W; Caffeine for Apnea of Prematurity Trial Group. Caffeine therapy for apnea of prematurity. N Engl J Med. 2006 May 18;354(20):2112-21. doi: 10.1056/NEJMoa054065. PMID: 16707748.
Henderson-Smart DJ The effect of gestational age on the incidence and duration of recurrent apnoea in newborn babies. Aust Paediatr J 1981
;17 (4):273-276 [PubMed]
Pergolizzi J, Kraus A, Magnusson P, Breve F, Mitchell K, Raffa R, LeQuang JAK, Varrassi G. Treating Apnea of Prematurity. Cureus. 2022 Jan 31;14(1):e21783. doi: 10.7759/cureus.21783. PMID: 35251853; PMCID: PMC889076
Barrington K, Finer N. The natural history of the appearance of apnea of prematurity. Pediatr Res. 1991 Apr;29(4 Pt 1):372-5. doi: 10.1038/pr.1991.72500. PMID: 1852531.
Dobson NR, Patel RM. The Role of Caffeine in Noninvasive Respiratory Support. Clinics in Perinatology. 2016 Dec;43(4):773-782. DOI: 10.1016/j.clp.2016.07.011. PMID: 27837758; PMCID: PMC5111868
REVIEW article Front. Pediatr., 24 October 2021, Sec. Neonatology
Volume 9 - 2021 | doi.org/10.338...
Schmidt B. Caffeine for Apnea of Prematurity: Too Much or Too Little of a Good Thing. J Pediatr. 2023 Aug;259:113488. doi: 10.1016/j.jpeds.2023.113488. Epub 2023 May 17. PMID: 37201684.
Apnoea of Prematurity and Neurodevelopmental Outcomes: Current Understanding and Future Prospects for Research Max Williamson1 Ravi Poorun2 Caroline Hartley1*
Mürner-Lavanchy IM, Doyle LW, Schmidt B, Roberts RS, Asztalos EV, Costantini L, Davis PG, Dewey D, D'Ilario J, Grunau RE, Moddemann D, Nelson H, Ohlsson A, Solimano A, Tin W, Anderson PJ; Caffeine for Apnea of Prematurity (CAP) Trial Group. Neurobehavioral Outcomes 11 Years After Neonatal Caffeine Therapy for Apnea of Prematurity. Pediatrics. 2018 May;141(5):e20174047. doi: 10.1542/peds.2017-4047. Epub 2018 Apr 11. PMID: 29643070.
Di Fiore JM, Arko M, Whitehouse M, Kimball A, Martin RJ. Apnea is not prolonged by acid gastroesophageal reflux in preterm infants. Pediatrics. 2005 Nov;116(5):1059-63. doi: 10.1542/peds.2004-2757. PMID: 16263989.
Yee AK, Siriwardhana LS, Nixson GM, Walter LM, Wong FY, Horne RSC. Developmental consequences of short apneas and periodic breathing in preterm infants. J Perinatol. 2023 Nov;43(11):1420-1428. doi: 10.1038/s41372-023-01748-8. Epub 2023 Aug 9. PMID: 37558750; PMCID: PMC10615736.
Janvier A, Khairy M, Kokkotis A, Cormier C, Messmer D, Barrington KJ. Apnea is associated with neurodevelopmental impairment in very low birth weight infants. J Perinatol. 2004 Dec;24(12):763-8. doi: 10.1038/sj.jp.7211182. PMID: 15329741.
Lopes, José Maria de Andrade. “[Neonatal apnea].” Jornal de pediatria 77 Suppl 1 (2001): S97-S103 .
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**TIMESTAMPS**
00:53 What is apnea of prematurity?
11:31 Treatment of Apnea of Prematurity
24:59 Outcomes of infants with apnea
27:30 When can we discharge babies who have had events?
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*Disclaimer*: This video is intended for educational purposes only and while we strive to give the most accurate information, errors may occur. Subsequently, this video should not be a replacement for medical advice.

[@Chris-di6nl]

Homework: Babies may have apnea due to IVH, hypoglycemia, flexed position, coanal atresia, or sepsis; Caffeine can help decrease inflammation in the lungs, increase long compliance, and increased chemo-sensitivity to increased CO2

[@TalaTalksNICU]

Wow that is super super impressive!!!!!! Really appreciate you watching until the end and having such a thorough understanding!

[@ahedalfa187]

Thanks a lot Dr. Tala, I have waiting a long time for this amazing lecture :).

[@TalaTalksNICU]

Oh great!! Sorry about the wait but so glad you liked it :)

[@susanwoods3507]

3 reasons to use Caffeine 1. Stimulates respiratory drive to help prevent AOP 2. According to research Caffeine may reduce a PDA 3. As a prophylaxis in the very early preterm infant when close to extubation. 5 reasons why infants have apnea - immature CNS, IVH, Sepsis, Airway obstruction, prematurity.

[@TalaTalksNICU]

Excellent!!!! Thank you for great summary!!!!

[@drsyedmm]

Every bit of information was worth watching. Thanks Dr Tala.

[@TalaTalksNICU]

What a lovely thing to write! Thank you so much for being here!

[@sedofsedof6435]

So nice Dr tala and thanks again for ur help in understanding difficult things in short time❤❤❤

[@TalaTalksNICU]

Comments like these keep us going- just want to say thank you so much for being here and taking the time to write!

[@unokdr9320]

So interesting and informative! Thank you!

[@TalaTalksNICU]

Thank you!! So glad you enjoyed it!!!

[@leenaomar9138]

Thank you Dr. Tala Soo informative and well explained We are thankful for all your efforts and the amazing way of explanation

[@TalaTalksNICU]

What a lovely comment! Thank you so much for being here and for taking the time to send a message! Very motivating words!

[@nathanielwissman7752]

Thank you so much Dr. Tala! Will you ever do a video on TORCH infections?

[@TalaTalksNICU]

URGH!!! I need to get on that!!!! I’m so sorry!!! Will get back to script and will have it out by fall!!! Sorry!!

[@nathanielwissman7752]

@@TalaTalksNICU Awesome!

[@lenaalsaleem3769]

Amazing explanation, thank you!!

[@TalaTalksNICU]

Oh wow! So glad you liked it- thank you!

[@abelitasousa6053]

There are some causes which are causing AOP such as : sepsis, Nec, PDA, IVH, metabolic disorder, hypocalcemia, hypoglycemia Caffeine can give orally or Iv for loading dose is 20mg/kg and after 24 hrs starts maintenance dose of 5 mg/kg if recurrent apnea may increase to 10mg/kg once daily. Thats all my answer 🙏

[@TalaTalksNICU]

This is fantastic!!! Also very impressed you watched until the end!! Thank you!!!

[@griffinanasi6646]

amazing waited for this for log Nairobi Kenya we are informed next on the line painmanagement and FCC kindly

[@TalaTalksNICU]

Urgh! Yes! Sorry! I said I’d do pain management!!!! Will get it done by end of the year!!!

[@Ebti-ic9il]

This is amazing.. thank you. I love caffeine too.. I was also hoping that you’d comment on caffeine “side effects” and when NOT to use or consider the dosing..such as in Tachycardia, NEC..

[@TalaTalksNICU]

You’re right- I should have discussed possible contraindications. Maybe we should make a short video about that? I keep psyching myself up to make shorts- they just don’t seem very us!!

[@kajolpk9366]

First comment.. 😘

[@TalaTalksNICU]

Love this! Ha! Makes us feel like a real KZbin channel!!!

[@jessical9293]

What happens if you bring a baby home and after a month has the events still ? Is that normal ?

[@gorakhmundhe8168]

Thank you mam ❤

[@TalaTalksNICU]

Most welcome 😊

[@drheshamelkordi8529]

Amazing 🎉 Any benefit of caffeine for tiny babies on CPAP?

[@TalaTalksNICU]

Yes definitely! If tiny babies not intubated - should be on Cpap to prevent events (and hopefully decrease BPD etc)

[@alaamosad3233]

Thank you Dr. For this interesting lecture,,can you talk about Surfactant in the same interesting way❤

[@TalaTalksNICU]

Yes! That’s a great topic of discussion!! Thank you so much!

[@drminmax7276]

how about apnea in term newborn ? can you have a detailed video for approaching this kind of situation? thank you from Viet Nam.

[@TalaTalksNICU]

Hello!!!! Yes! We should cover this- I really want to start a series of symptoms and then follow it through that way. What we should do next!!!

[@rasoulhoma8007]

Thank you so much

[@TalaTalksNICU]

Thank you for being here!!!