Apnea, Pediatric
Basics
Description
Description
- Absence of respiratory airflow for a period of 20 s, with or without decreased heart rate:
- Central apnea:
- Disruption in the generation or propagation of respiratory signals in the brainstem and descending neuromuscular pathways
- Obstructive apnea:
- Respiratory effort is present, but there is no airflow
- Structural airway obstruction, often with paradoxical chest wall movement
- Functional obstruction from airway collapse
- Mixed
- Central apnea:
- Brief resolved unexplained events (BRUE):
- Episode in an infant <1 yr that is sudden, brief, and now resolved and associated with 1 or more of the following:
- Cyanosis or pallor
- Absent, decreased, or irregular breathing
- Marked change in tone
- Altered level of responsiveness
- A clinical presentation and diagnosis of exclusion after appropriate history and physical exam
- Episode in an infant <1 yr that is sudden, brief, and now resolved and associated with 1 or more of the following:
Etiology
Etiology
- Infection:
- Sepsis
- Meningitis or encephalitis
- Pneumonia
- Pertussis/chlamydia
- RSV and other viral respiratory infections
- Respiratory:
- Obstructive airway lesions:
- Enlarged tonsils and adenoids
- Vocal cord dysfunction
- Laryngotracheomalacia
- Vascular ring
- Foreign body
- Craniofacial abnormality
- Choanal atresia or stenosis
- Functional obstruction from airway collapse
- Infection
- Immaturity/prematurity
- Abnormal ventilatory response to hypoxia/hypercarbia
- Obstructive airway lesions:
- Neurologic:
- Seizure
- Intracranial hemorrhage
- Increased intracranial pressure
- Tumor
- Arnold–Chiari or other CNS malformation
- Ingestion
- Toxin
- Carbon monoxide
- Hypoxic injury
- Neuromuscular disorder
- Central hypoventilation syndrome
- Cardiac:
- Dysrhythmia
- Congenital heart disease
- CHF
- Myocarditis
- Cardiomyopathy
- GI:
- GERD
- Volvulus
- Intussusception
- Child abuse
- Endocrine/metabolic:
- Hypoglycemia
- Electrolyte disorders
- Inborn errors of metabolism
- Other:
- Transient choking episode
- Laryngospasm
- Periodic breathing
- Breath-holding spell
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Citation
Schaider, Jeffrey J., et al., editors. "Apnea, Pediatric." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307125/all/Apnea_Pediatric.
Apnea, Pediatric. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307125/all/Apnea_Pediatric. Accessed November 7, 2024.
Apnea, Pediatric. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307125/all/Apnea_Pediatric
Apnea, Pediatric [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 November 07]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307125/all/Apnea_Pediatric.
* Article titles in AMA citation format should be in sentence-case
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T1 - Apnea, Pediatric
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ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
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