No airflow, disorganized chest movements continue. A pattern of at least 3 cycles of regular respirations of 10-18 seconds each interrupted by pauses of at least three seconds. Reported as the percentage of quiet time spent in this pattern. Many disorders present with onset or worsening of apnea, often via the final common pathway of hypoxia. Infection, shock, necrotizing enterocolitis , congestive heart failure, patent ductus arteriosus , hypo- or hyperthermia, anemia.
Apnea of prematurity is, therefore, a diagnosis of exclusion.
Alternately, caffeine can be given to increase CO2 sensitivity, stimulate diaphragmatic contraction, decrease muscle fatigue, and increase metabolic rate and catecholamine activity. Theophylline is better in cases with BPD as it also inhibits bronchospasm. Intubate if necessary for severe or recalcitrant cases. Other causes of events may produce different patterns. Chest wall movement itself does not prove air movement.