These are cessation of breathing for 15–20 seconds, often accompanied by bradycardia. Apnoeic attacks are most commonly due to prematurity, but may accompany sepsis, hypoglycaemia, hypoxaemia, hypothermia, hyperthermia.
- Features of the predisposing condition.
- Screen for sepsis – full blood count, blood culture
- Blood glucose levels
- Re-establish breathing by gentle stimulation. If poor response ventilate using bag and mask.
- For apnoea of prematurity give caffeine citrate 20mg/kg orally or IV over 30 minutes. If caffeine is not available use IV aminophylline 10mg/kg over 15–30 minute. Maintenance doses should be given at 5mg/kg/day. Avoid rectal
aminophylline; it may not achieve therapeutic levels. In all cases monitor heart rate.
- IV fluids according to the daily needs.
- Avoid oral feeding to prevent aspiration
- Treat the cause if known.
- If frequent give continuous oxygen by nasal catheter.
- In recurrent cases continuous positive airway pressure (CPAP) may be useful. This can be done in a neonatal intensive care unit (NICU)
- Monitor frequently.