The incomplete development of the respiratory system and the areas of the brain that regulate respiration is a common problem in premature infants, with increasing severity in low birth weight infants. This condition results in episodes of spontaneous apnea, which is usually defined as a cessation of breathing that lasts more than 20 seconds.
Clinically, this interruption may be accompanied by a slower heart rate and/or a reduction in the amount of oxygen in the blood. Lastly, infants who suffer from apnea may have a pale or cyanotic tone of skin, along with a reduction in muscle tone. Low gestational age is associated with an increased risk of episodes of apnea, which usually begins in the first few days of life.
Less severe episodes can be resolved by tactile stimulation of the newborn, while more severe episodes require pharmacological intervention with stimulant drugs, such as caffeine.
Adenosine is a neurotransmitter that modulates brain neuronal activity and inhibits respiration effort. Caffeine directly opposes this effect by blocking the interaction of adenosine with its cellular receptors, thus resulting in a stimulus to reactivate respiration.
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