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November Case Study on Apnea of Prematurity

*Multiple Choice Questions are towards the bottom of this blog.


Baby A., a female preterm infant born at 28 weeks gestation, was delivered via spontaneous vaginal delivery due to premature rupture of membranes (PROM) and preterm labor.


Her birth weight was 1.2 kg. Initially, she was placed in an incubator in the NICU and received supplemental oxygen via nasal cannula.


On her second day, Baby A. began experiencing frequent apnea episodes. Some episodes lasted more than 20 seconds and were accompanied by a drop in oxygen saturation to 82% and bradycardia (heart rate of 75 bpm).


The NICU team administered tactile stimulation to resolve some of these episodes, but caffeine citrate was initiated due to continued apnea to reduce the episodes' frequency.



Vital Signs at the Time of Intervention:


- Heart Rate: 140 bpm (baseline)

- Respiratory Rate: 45 breaths per minute

- Temperature: 36.8°C

- Oxygen Saturation: 90% with supplemental oxygen



After the caffeine citrate was administered, Baby A.’s apnea episodes decreased, but she still experienced a few during feeding times. To manage these episodes, the NICU team switched her oxygen delivery from a nasal cannula to CPAP to provide continuous airway support.


Multiple Choice Questions


What factor likely contributed to Baby A.’s increased risk of apnea of prematurity?

  • A. Being born at 28 weeks gestation

  • B. Receiving oxygen via nasal cannula

  • C. Weighing more than 1.5 kg at birth

  • D. Delivering via vaginal delivery


2. Baby A was switched from nasal cannula to CPAP. What is the main advantage of using CPAP in treating prematurity apnea?

  • A. It provides high oxygen levels to prevent apnea

  • B. It keeps the airways open, reducing collapse

  • C. It enables the infant to breathe independently

  • D. It blocks all apnea episodes altogether


3. At what corrected gestational age do apnea episodes typically resolve in preterm infants, allowing for the discontinuation of management interventions?

  • A. 28-30 weeks

  • B. 31-33 weeks

  • C. 34-36 weeks

  • D. 40-42 weeks



EVIDENCE CORNER


TOPIC: Prophylactic methylxanthine for prevention of apnoea in preterm infants

David J Henderson-Smart, Antonio G De Paoli (2010)



Author conclusion: Prophylactic methylxanthine was shown to reduce the duration of the need for positive pressure ventilation and the rate of PDA ligation, but no direct indication that it will decrease or stop the incidence of severe apnea.  


Citation: AU: Henderson‐Smart DJ  AU: De Paoli AG

TI: Prophylactic methylxanthine for prevention of apnoea in preterm infants

SO: Cochrane Database of Systematic Reviews YR: 2010. CC: [Neonatal]

DOI: 10.1002/14651858.CD000432.pub2US: https://doi.org//10.1002/14651858.CD000432.pub2

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7 commentaires


Invité
15 nov.

Thanks for the update . Very educative

J'aime

JULIA
12 nov.

Brilliant!!!

J'aime

good

J'aime

Very informative

J'aime

Invité
10 nov.

Good

J'aime
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