A 3-Week-Old Boy Is Evaluated in the Neonatal Intensive Care

A 3-week-old boy is evaluated in the neonatal intensive care unit due to apnea.  The patient was born at 27 weeks gestation and had a birth weight of 1 kg (2 lb 2 oz) .  For the past 2 weeks, he has been stable on minimal respiratory support via nasal cannula but has had intermittent episodes of no respiratory effort for up to 30 seconds at a time.  These episodes are associated with bradycardia and desaturation.  The patient recovers spontaneously or with brief stimulation from the nurse.  He is well appearing between episodes.  Examination of the lungs reveals bilateral, clear breath sounds with easy work of breathing.  Ultrasound of the head is normal.  Arterial blood gas values are normal.  This patient's clinical findings are most likely caused by an abnormality in which of the following areas?

A) Central stimulatory neurons
B) Lower motor neurons
C) Mixed motor sensory nerves
D) Peripheral chemoreceptors
E) Pulmonary stretch receptors

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