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Cardiorespiratory events recorded on home monitors: the effect of prematurity on later serious events
G Naulaers1, H Daniels, K Allegaert
1Department of Paediatrics, University Hospital Leuven, Belgium. gunnar.naulaers@uz.kuleuven.ac.be
Insights
Infants born prematurely who had abnormal sleep studies require home monitoring. Younger infants at birth had more frequent and later alarms, indicating a higher risk of home events.
Area of Science:
- Neonatal Medicine
- Pediatric Pulmonology
- Sleep Medicine
Background:
- Premature infants often experience cardiorespiratory events.
- Home monitoring is used to manage these events after hospital discharge.
Purpose of the Study:
- To characterize severe alarms in prematurely born infants using home monitoring.
- To identify risk factors associated with these alarms.
Main Methods:
- Polysomnography was performed on infants with post-menstrual age (PMA) < 35 weeks before discharge.
- Abnormal events included heart rate < 50 bpm or prolonged apnea.
- Infants received cardiorespiratory home monitoring; severe alarms were defined as HR < 50 bpm for > 3 seconds.
Main Results:
- 96 of 1058 infants required home monitoring, with 61 experiencing alarms.
- The mean post-conceptional age (PCA) for alarm cessation was 46 weeks.
- A significant negative correlation existed between PMA at birth and PCA of last alarm (r = -0.46, p = 0.0002).
Conclusions:
- Premature infants with abnormal polysomnography results at discharge are at increased risk for home-related acute events.
- A lower PMA at birth is associated with a higher likelihood of experiencing alarms at a later PCA.
Objective:
To describe severe alarms on home-documented monitoring in infants born prematurely.
Methods:
In infants born at a post-menstrual age (PMA) less than 35 weeks, a polysomnography was performed before discharge. A heart rate less than 50 beats per minute (bpm) for more than 3 seconds or an apnea lasting for more than 15 seconds with a heart rate less than 60 bpm were defined as abnormal. These babies were given cardiorespiratory home monitoring with memory. Serious alarms on the home monitor were defined as heart rate less than 50 bpm for more than 3 seconds.
Results:
Of 1058 infants, 96 infants needed cardiorespiratory home monitoring. Sixty-one infants showed alarms at home. The mean post-conceptional age (PCA) when alarms stopped was 46 weeks. Seventeen patients had serious alarms above the PCA of 50 weeks. There was a significant negative correlation (r = -0.46 and p = 0.0002 by Spearman's rank correlation) between the PMA at birth and the PCA at which the last alarm was noted
Conclusion:
Prematurely born infants with an abnormal polysomnography at discharge are at high risk for developing acute events at home. A younger PMA at birth correlates with a higher risk of alarms at a later PCA.
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