Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio, USA.
Compr Physiol. 2012 Oct;2(4):2923-31. doi: 10.1002/cphy.c100021.
Apnea of prematurity is a significant problem due to immaturity of the central neural control circuitry responsible for integrating afferent input and central rhythm. In this review, we provide an overview of the pathogenesis of apnea of prematurity--including our current understanding of the role that afferent input to the brain stem plays in synergy with the central pattern generation circuitry in the emergence of apnea of prematurity. We then discuss the interplay of apnea, bradycardia, desaturation, as well as the genesis of central, mixed, and obstructive apnea. Finally, we provide a summary of the physiological basis for current therapeutic approaches to treating apnea of prematurity, and conclude with an overview of proposed long-term consequences of the resultant intermittent hypoxic episodes.
早产儿呼吸暂停是一个重大问题，这是由于中枢神经控制回路不成熟所致，该回路负责整合传入输入和中枢节律。在这篇综述中，我们提供了早产儿呼吸暂停发病机制的概述，包括我们目前对脑干传入输入在早产儿呼吸暂停出现时与中枢模式生成回路协同作用的理解。然后，我们讨论了呼吸暂停、心动过缓、脱氧、以及中枢性、混合性和阻塞性呼吸暂停的发生之间的相互作用。最后，我们总结了目前治疗早产儿呼吸暂停的治疗方法的生理基础，并概述了由此产生的间歇性缺氧发作的长期后果。
