RT Book, Section A1 Gomella, Tricia Lacy A1 Cunningham, M. Douglas A1 Eyal, Fabien G. A1 Tuttle, Deborah J. SR Print(0) ID 1107527639 T1 Apnea and Bradycardia (“A's and B's”) T2 Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 7e YR 2013 FD 2013 PB McGraw-Hill Education PP New York, NY SN 9780071768016 LK accesspediatrics.mhmedical.com/content.aspx?aid=1107527639 RD 2024/10/09 AB An infant has just had an apneic episode with bradycardia. Apnea is the absence of breathing for >20 seconds or a shorter pause (>10 seconds) associated with oxygen desaturation or bradycardia (50% of infants 50%).Periodic breathing. Three or more respiratory pauses lasting >3 seconds separated by normal respiratory intervals not >20 seconds and not associated with bradycardia. Periodic breathing can occur in 2–6% of healthy term neonates and in up to 25% of preterm infants.Apnea of infancy (AOI). American Academy of Pediatrics (AAP) definition: “an unexplained episode of cessation of breathing for 20 seconds or longer or a shorter respiratory pause associated with bradycardia, cyanosis, pallor, and/or marked hypotonia” in an infant >37 weeks' gestational age.Apnea of prematurity (AOP). Sudden absence of breathing that lasts at least 20 seconds or is associated with bradycardia or cyanosis (oxygen desaturation) in an infant <37 weeks' gestational age. It is most commonly central or mixed apnea. AOP is a developmental disorder usually of physiologic immaturity of respiratory control but other diseases may contribute. AOP may be hereditary. AOP usually presents on days 2–7. If apnea presents in the first 24 hours of life or after day 7, it is very unlikely to be AOP. Note: Apnea of prematurity is a diagnosis of exclusion.Persistent apnea. Apnea persists in a neonate ≥37 weeks postmenstrual age. It usually occurs in infants born at <28 weeks' gestation.Secondary causes of apnea. Apnea that has a specific cause (eg, sepsis, anemia, asphyxia, temperature instability, pneumonia, and others). Remember immaturity can worsen any apnea that is associated with a specific cause.