Novorođenačka apneja

master's thesis

• Title (english): Neonatal apnea
• Author: Marija Marušić
• Mentor: Boris Filipović-Grčić (mentor)
• Committee member: Mirta Starčević (predsjednik povjerenstva)
• Committee member: Marija Jelušić (član povjerenstva)
• Committee member: Boris Filipović-Grčić (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Pediatrics); Zagreb
• Defense date and country: 2021-07-16, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Pediatrics

Abstract

Sve prestanke disanja novorođenčeta duže od 20 sekundi te kraće prestanke disanja popraćene bradikardijom i/ili hipoksemijom smatramo novorođenačkom apnejom. Najčešća je apneja nedonošenosti tj. idiopatska apneja. Etiologija ovog kliničkog entiteta nije u potpunosti razjašnjena, ali ključnim se etiološkim čimbenikom smatra nezrelost respiratorne kontrole. Od apneje nedonošenosti oboli gotovo sva nedonoščad rođena prije 28. tjedna trudnoće te praktički svi porodne mase manje od 1000 grama, a incidencija se smanjuje sukladno napredovanju korigirane dobi trudnoće. Obično se prva apneja detektira uređajem za nadzor disanja 2. ili 3. dan života, a do rezolucije najčešće dolazi u razdoblju od 36. do 40. tjedna korigirane dobi trudnoće. Prognoza je dobra, ali potencijalne dugoročne posljedice tek treba istražiti. Središnju ulogu u terapiji ima kofein. Njegovo se djelovanje zasniva na centralnoj stimulaciji disanja, a pokazao se jednostavnijim za primjenu i sigurnijim od drugih metilksantina. Često je u terapiju potrebno uvesti i neinvazivnu ventilaciju. Najčešće se primjenjuje nCPAP, ali istraživanja pokazuju potencijalne koristi primjene drugih modaliteta NIV-e kao što su biPAP, NAVA i HFNC. Manji se broj apneja ne može razriješiti primjenom navedenih metoda liječenja pa je neophodno uvesti invazivnu mehaničku ventilaciju. Iako rjeđe, novorođenačka se apneja javlja i u terminski rođene djece, uglavnom kao posljedica djelovanja raznih precipitirajućih čimbenika i bolesti pa njena rezolucija u ove novorođenčadi ovisi o liječenju primarne patologije.

Abstract (english)

Neonatal apnea is defined as any cessation of breathing longer than 20 seconds or shorter cessations of breathing accompanied by bradycardia and/or hypoxemia. The most common is apnea of prematurity, also known as idiopathic apnea. The etiology of this clinical entity is not yet fully understood, but the most important etiological factor is considered to be immaturity of respiratory control. Almost all premature newborns born at less than 28 weeks of gestation and practically all who weigh less than 1000 grams at birth suffer from apnea of prematurity, but its incidence decreases in accordance with increasing postmenstrual age. Apnea is usually first detected by cardiorespiratory monitoring device on the second or third day of life and its resolution usually occurs between 36 and 40 weeks of postmenstrual age. Prognosis is good but potential long-term effects are yet to be investigated. Caffeine plays a central role in therapy. Its action is based on central stimulation of breathing and it has been shown as safer and easier to administer than other methylxanthines. The therapy often requires noninvasive ventilation. The most commonly used is nCPAP, but research shows the potential benefits of applying other NIV modalities such as biPAP, NAVA and HFNC. A small number of apneas cannot be resolved by applying the treatment methods mentioned above, so it is necessary to introduce invasive mechanical ventilation. Although less commonly, neonatal apnea also occurs in full term infants, mainly as a result of various precipitating factors and diseases, so its resolution in these newborns depends on the treatment of primary pathology.

• Keywords: novorođenačka apneja; apneja nedonošenosti; kofein; NIV; neinvazivna ventilacija
• Keywords (english): neonatal apnea; apnea of prematurity; caffeine; NIV; noninvasive ventilation
• Language: croatian
• URN:NBN: urn:nbn:hr:105:708348
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2022-03-11 10:22:43