Apnea, Pediatric is a topic covered in the 5-Minute Emergency Consult.

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Emergency Central

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Basics

Description

  • Absence of respiratory airflow for a period of 20 sec, 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
  • Apparent life-threatening event (ALTE):
    • Episode that is associated with a combination of apnea, color change, change in tone, choking, or gagging
    • A clinical presentation, not a diagnosis

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
  • 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

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TY - ELEC T1 - Apnea, Pediatric ID - 307125 Y1 - 2016 PB - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307125/all/Apnea__Pediatric ER -