Summary of the Article Control of Breathing and Neonatal Apnea
Summary of the Article Control of Breathing and Neonatal Apnea
Introduction and Classification of Apnea and Respiratory Patterns
In the article Control of Breathing and Neonatal Apnea, the authors, Richard J. Martin and Jalal M. Abu- Shaweesh seek to delve into the pathophysiological perspective apnea of prematurity. During fetal development, infants are expected to have a smooth transition in the development of their respiratory system, but that is not always the case, preterm babies may experience difficulty resulting to respiratory pauses that may lead to apnea in premature infants. The authors seek to bring to light the issue of apnea of prematurity while focusing on the therapies that are used to handle it as well as the implications these therapies might have in preterm infants in the long term. It becomes clear that there are different Apnea respiratory patterns, and they include immature respiratory patterns, ventilatory response to hypercapnia, and ventilatory response not forgetting hypoxia and ventilatory responses to laryngeal afferents.
According to the authors, apnea of prematurity may present a sign for other diseases the infant might have, and many of these diseases affect these preterm infants. Depending on the respiratory patterns of apnea an infant may be having, different therapeutic approaches are recommended which are aimed at solving the problem. Depending on the various mechanisms of treatment employed, various therapeutic treatments are used. The most recommended ones are xanthines and continuous positive airway pressure. Xanthines have been used for some time now in which case caffeine, and theophylline is administered rectally and is aimed at helping “increase minute ventilation improves sensitivity, decreases hypoxic depression of breathing.” (Martin & Abu- Shaweesh, 2005). When it comes to continuous positive airwave pressure, there is the splinting of the upper airwave with the aid of so as to decrease chances of pharyngeal or laryngeal obstruction. The main function of this therapy is to increase the oxygenation capacity of the lungs.
Other Therapeutic Approaches
Also, the authors focus on other therapeutic approaches to apnea of prematurity because they are all geared towards ensuring the well- being of the infants. Some of these therapeutic treatments only require physical treatment like skin- to- skin nursing whereby no medicine is recommended. In the handling of apnea in preterm infants, it is highly recommended that focus is put on optimal oxygen saturation. In the case of frequent refluxes, gastric acidity should be prevented. But then, it is highly recommended that future researches should put a lot of emphasis on the existence of subgroups that might require specific types of therapeutic treatments just so as to be specific treatments for specific apnea. That way, there will be increased chances of having to separate different treatment mechanisms instead of trying even those measures that may not work with some of the patterns.
Relevance of the Therapeutic Approaches and possible Outcome
Apnea of prematurity ends by the fortieth week after birth but might persist in few cases of more premature infants (Brodsky & Oullette, 2008). But that does not rule out the imminent possibility of infants having this problem after that and that helps create a thin line between sudden infant death and apnea of prematurity. That helps identify the link between the two because they mostly affect preterm infants. All said and done; the authors bring out an analysis of this condition and how best to go about it, but most of all, they analyze the different types of treatment given as well as all that is lacking in them. The recommendations offered help bring out some of the inefficiencies in previous studies and possible areas of study in the future.
My Opinion
The research is very informative and gives insights into the care and treatment of apnea in prematurity. The condition is classified a s a neonatal disorder of the central nervous system. The good thing is that the authors give their insights according to the studies they have done and possible areas to be studied in future but then there is lack of conclusive background information about this condition. Nevertheless, all is not lost because there is a lot that has been covered in the quest to increase survival for the affected preterm infants.
References
Brodsky, D. & Oullette, M. A. (2008). Primary Care of the Premature Infant. Philadelphia: Saunders Elsevier.
Martin, R. J. & Abu- Shaweesh, J. M. (2005). Control of Breathing and Neonatal Apnea. Biology of the Neonate. Web. Retrieved from http://citeseerx.ist.psu.edu/viewdoc/download;jsessionid=A09E2DDE80BF361854D7D 72D90B8B7B?doi=10.1.1.631.2396&rep=rep1&type=pdf
