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Olfactory Stimulation Prevents Apnea in Premature Newborns. Marlier L, Gaugler C, and Messer, J. Pediatrics (Jan 2005); 115: 83-88.
Objective. Methylxanthines and doxapram are currently used to treat apnea of prematurity but are not fully effective and often present undesirable side effects. The present study examines whether exposure to an odor known to modulate the infant's respiratory rate could reduce the frequency of apneic spells.
Method. Fourteen preterm newborns born at 24 to 28 gestational weeks presenting recurrent apnea despite caffeine and doxapram therapy were exposed to a pleasant odor diffused during 24 hours in the incubator. Efficiency of the olfactory treatment was judged by comparing frequency and severity of apneas occurring during the day of odorization with that observed the day before (baseline) and the day after (posttreatment control). Apnea was defined as any complete cessation of breathing movements for >20 seconds, or less if associated with hypoxia or bradycardia.
Results. Concerning all types of apneas, a diminution of 36% was observed and seen in 12 of 14 infants. Apneas without bradycardia were reduced (44%) during the day with odorization, and this diminution affected all the infants. The frequency of apnea with moderate bradycardia (heart rate between 70 and 90 beats per minute) was maintained while the frequency of apnea associated with severe bradycardia (heart rate <70 beats per minute) decreased strongly (45%) and affected all the infants. No side effects were observed.
Conclusion. The introduction of a pleasant odor in the incubator is of therapeutic value in the treatment of apneas unresponsive to caffeine and doxapram.
Comments: The pleasant aroma used in this study was
vanillin, and it was applied to the periphery of the infant’s pillow inside
the isolette. Previous studies of the ability of premature infants to detect
odors, led to the discovery that this odor actually stimulated respirations in
these babies. The present study found a significant beneficial effect of
“aroma therapy” in a population of premature infants with severe apnea of
prematurity that was unresponsive to conventional medical therapies. Now that
we have documentation of efficacy, it would be nice to see a head to head
trial of “aroma therapy” vs. caffeine or doxapram. What’s next? Will we see
different aromas used to relieve pain, reduce anxiety, stimulate appetite, or
even enhance neurodevelopmental outcomes?? ABK.
Date: 17 Jan 2005
Time: 15:11:35
One problem I see with the possibility of these kind of therapy is that the 'olfatory system' rapidly blocks the input so after a little while you become accustomed to that 'aroma' (pleasant or not). Ask the garbage collection workers.
UserName: Felix A. Estrada, M.D.
Institution: Parkway Regional Medical Center
telephone: 305-654-5612
email:
felixaestradamd@pol.net
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