Apnea in acute bilirubin encephalopathy.

Apnea in acute bilirubin encephalopathy.
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DOI:
10.1053/j.semperi.2014.08.003
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发表时间:
2014-11
影响因子:
3.4
通讯作者:
Watchko JF
Watchko JF
中科院分区:
医学3区
文献类型:
--
作者:
Amin SB;Bhutani VK;Watchko JF

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中枢性呼吸暂停,定义为呼吸停止≥20秒,常见于妊娠< 34周的早产儿,但在健康的晚期早产儿(妊娠340/7 - 366/7周)和足月婴儿(妊娠≥37周)中并不常见,后者通常是神经或代谢问题的临床表现。越来越多的证据表明,明显的非共轭高胆红素血症与新生儿中枢性呼吸暂停有关。本文探讨已报道的新生儿急性胆红素脑病与症状性呼吸暂停事件之间的关联,以及这一现象发生的可能机制。急性胆红素脑病报告中有症状性窒息事件的流行表明,这一临床发现应被视为胆红素神经毒性的迹象。
Central apnea, defined as cessation of breathing for ≥ 20 seconds, is frequent in premature infants born < 34 weeks gestation but uncommon among healthy late preterm (340/7 – 366/7 weeks gestation) and term (≥ 37 weeks gestation) infants where it is usually a clinical manifestation of a neurological or metabolic problem. There is growing evidence that marked unconjugated hyperbilirubinemia is associated with central apnea in neonates. This paper explores the reported association between acute bilirubin encephalopathy and symptomatic apneic events in newborns and the possible mechanisms involved in the pathogenesis of this phenomenon. The prevalence of symptomatic apneic events in reports of acute bilirubin encephalopathy suggests this clinical finding should be considered a sign of bilirubin neurotoxicity.
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