Home monitoring in Hawaii: the first 1,000 patients

Area of Science:

• Pediatrics
• Neonatal Care
• Medical Devices

Background:

• Home cardiorespiratory monitoring is increasingly used for infants.
• Indications include apnea of prematurity, Apparent Life-Threatening Episodes (ALTE), and SIDS (Sudden Infant Death Syndrome) sibling monitoring.
• By 1986, Hawaii monitored 12.3/1000 live births.

Purpose of the Study:

• To assess the utilization and outcomes of home cardiorespiratory monitoring for infants in Hawaii.
• To evaluate parental satisfaction and identify challenges associated with the monitoring program.

Main Methods:

• Retrospective review of 1,000 infants prescribed home cardiorespiratory monitors by February 1988.
• Analysis of monitoring duration, reasons for discontinuation, and infant outcomes.
• Parental feedback collected via a quality assurance questionnaire.

Main Results:

• 27% of monitored infants experienced documented apnea or bradycardia.
• 17 infant deaths occurred among monitored patients; 2 were unmonitored at the time of death.
• Most parents reported high satisfaction, viewing monitors as reassuring, but equipment performance was a major concern.

Conclusions:

• Home cardiorespiratory monitoring is utilized for various infant conditions in Hawaii.
• While generally well-received by parents, equipment reliability is a significant issue.
• The program identified infants with significant cardiorespiratory events, underscoring the clinical utility of monitoring.