PECULIARITIES OF APNEA AND PERIODIC RESPIRATORY EPISODES IN PREMATURE CHILDREN SUFFERING BRONCHOPULMONARY DYSPLASIA
Abstract
At present, premature birth is one of the serious problems of perinatology, obstetrics and pediatrics in connection with the occurrence of serious complications for both the fetus and the mother. One of the most common respiratory pathologies in infants born prematurely is bronchopulmonary dysplasia (BPD). Approximately 25 % of infants diagnosed with moderate to severe BPD develop pulmonary hypertension (PH), which significantly affects clinical outcomes. Most infants with very low birth weight (< 1500 grams) are susceptible to apnea episodes due to immaturity of brain stem structures and peripheral chemoreceptors. The problem of respiratory disorders in sleep in premature infants has long attracted the attention of foreign researchers, but insufficient data have been accumulated on the features of respiratory disorders in sleep in premature infants suffering from bronchopulmonary dysplasia complicated by pulmonary hypertension. Narrow airway lumen due to its small diameter, development of muscular hypotension, which subsequently contributes to the occurrence of upper airway obstruction, the use of artificial ventilation for a long time interval, leading to the development of inflammation and, as a result, narrowing upper airway, immature respiratory control characteristic of premature infants, contribute to the appearance of intermittent (periodic) hypoxemic episodes manifested during apnea and periodic respiration events and, as a consequence, frequent changes in oxygen saturation. In order to diagnose episodes of apnea and periodic breathing, polysomnographic methods are used that make it possible to carry out a comprehensive diagnosis of respiratory disorders in sleep, to differentiate the type of apnea episodes necessary for an individual approach to therapy.
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