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1. SPECIAL NEONATAL DISORDERS
Presented by,
L.SOUNDARYA
M.SC.NURSING
(PEDIATRICS)

2. • APNEA
• MECONIUM ASPIRATIONS
• ATELECTASIS
• BRONCHOPNEUMONIA DYSPLASIA
• PULMONARY DYSMATURITY
• RETROLENTAL FIBROPLASIAS
• NECROTISING ENTEROCOLITIS
• INTRAVENTRICULAR HAEMORRHAGE
• HYPERBILIRUBINEMIA
• IRDS

3. APNEA
• When the cession of respiration is
more prolonged than that
associated with periodic breathing,
usually 10-20 seconds or longer and
is followed by color change and
bradycardia, the condition is called
apnea.

4. DEFINITION
• Apnea is a "pause in
breathing of longer than 10 to
15 seconds, often associated
with bradycardia, cyanosis, or
both." (Martin et al)..

5. Etiology
• Intracranial hemorrhage
• Physiological anemia
• Patent ductus arteriosis
• Pneumonia or sepsis
• Hypoglycemia, hypocalcaemia
• Gastrointestinal - NEC or gastro-esophageal reflux
• Temperature Regulation - Hypothermia or
hyperthermia
• Drugs - (narcotics, beta-blockers). Postnatal
exposure to sedatives, hypnotics or narcotics.

6. PATHOPHYSIOLOGY
1.Central apnea
2.Obstructive apnea
3. Mixed apnea

7. features
• Bradycardia (below 80-100 beats /minute) appears
30 seconds after cessation of respiration.
• Apnea in premature infants can result in a failure of
the mechanisms that protect cerebral blood flow,
resulting in ischemia and eventually leukomalacia.
• During apneic episodes, in an attempt to protect
cerebral blood flow cardiac output is diverted away
from the mesenteric arteries resulting in intestinal
ischemia and possibly NECROTIZING
ENTEROCOLITIS (NEC).

8. Nursing Management
Close monitoring of the baby
• Gentle sensory stimulation-to initiate the
breathing
• (Rubbing the back, stroking the face, chest,
and legs.)
• suctioning and resucitation
• Oro-gastric tube can be inserted – to
decompress the stomach
• Bradycardia- continues- mechanical ventilation
is necessary
• Primary management is Oxygen therapy

9. • Theophylline can be given as
intravenously.
• When alarm sounds, the nurse must
make an immediate effort to stimulate
or resuscitate the infant.
• Caffeine has also been found to improve
ventilation and to establish more
regular breathing pattern through CNS
stimulation.

10. Pharmacotherapy :*caffeine iv
Loading dose : 20mg /kg/dose
Maintenance dose: 5mg / kg/ day
*theophylline: loading dose:6mg/kg/dose
Maintenanance dose: 6mg/kg/day iv

12. • Continuous Positive
Airway Pressure (CPAP) -
CPAP is effective in
treating both obstructive
and mixed apnea, but
not central apnea.
• CPAP is most commonly
delivered by nasal prongs
or by an endotracheal
tube placed in the
nasopharynx.

13. Problems of apnea
• Hypoxia
• Cyanosis
• Brain damage
• Death

14. THANK YOU