Interventions for apnoea of prematurity: a personal view

摘要: Aim:  To review treatments for apnoea of prematurity (AOP). Methods:  Literature Review and description personal practice. Results:  Provided that symptomatic has been ruled out, interventions to improve AOP can be viewed as directed at one three underlying mechanisms: (i) a reduced work breathing [e.g. prone positioning, nasal continuous positive airway pressure (CPAP)], (ii) an increased respiratory drive (e.g. caffeine), (iii) improved diaphragmatic function branched-chain amino acids). Most options currently applied, however, have not yet shown effective and/or safe, except prone, head-elevated synchronized ventilation/CPAP, caffeine. Conclusion:  Treatment usually follows incremental approach, starting with followed by caffeine (which should started early, least in infants <1250 g), ventilation or CPAP via variable flow systems reduce breathing. From research point view, we most urgently need data on the frequency severity bradycardia intermittent hypoxia tolerated without putting infant risk impaired development retinopathy prematurity.