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Pneumogram recordings in infants resuscitated for apnea of infancy
J Oren1, D H Kelly, D C Shannon
1Pediatric Pulmonary Unit Childrens' Service, Massachusetts General Hospital, Boston.
Insights
The pneumogram, a cardiorespiratory monitoring tool, cannot predict adverse outcomes in infants with apnea of infancy. However, it reveals subtle differences in heart and respiratory rates compared to healthy infants.
Area of Science:
- Pediatrics
- Neonatology
- Cardiorespiratory Physiology
Background:
- Infants experiencing apnea of infancy requiring resuscitation face elevated risks of sudden infant death syndrome (SIDS).
- The pneumogram is a common diagnostic tool used in evaluating cardiorespiratory events in infants.
Purpose of the Study:
- To assess the predictive value of the initial pneumogram in identifying infants with apnea of infancy at high risk for adverse outcomes.
- To compare cardiorespiratory parameters from pneumograms of infants with severe apnea against a control group.
Main Methods:
- Analysis of the first pneumogram from 51 infants with a history of apnea of infancy requiring resuscitation.
- Classification of infants into groups based on subsequent monitored outcomes: death, resuscitation/stimulation, or no significant events.
- Blinded computer analysis comparing pneumogram results between outcome groups and a matched control group.
Main Results:
- No significant differences in pneumogram analysis were found between infants who died, required resuscitation, or had no significant subsequent episodes.
- Pneumograms did not differentiate infants who would experience further apneic spells or adverse events.
- Infants with apnea of infancy exhibited significantly higher mean respiratory rates, heart rates, and tachycardia indexes compared to controls.
Conclusions:
- The initial pneumogram is not a reliable predictor of adverse outcomes in infants with severe apnea of infancy.
- Subtle cardiorespiratory differences, including elevated heart and respiratory rates, are detectable in infants with apnea of infancy via pneumography.
Abstract:
Infants who sustained a spell of apnea of infancy during which they were resuscitated have been shown to be at increased risk for sudden infant death syndrome. To determine the value of the pneumogram as a predictor of outcome in this population, the first pneumogram obtained of 51 such infants was analyzed. The infants were grouped on the basis of subsequent outcome during a course of monitoring: group 1--infants who died during a subsequent event; group 2--infants who received resuscitation or vigorous stimulation to terminate a subsequent spell; group 3--infants who survived and did not have a significant subsequent episode. The results for these infants were compared with those of a control group matched for age and sex. A detailed, blinded computer analysis revealed no significant difference in the results of the pneumogram analysis between the three groups. It did not identify the infants in whom apneic spells necessitating resuscitation subsequently developed or those who died. However, when compared with the control group, infants with apnea of infancy had significantly higher mean respiratory rates, heart rates, and tachycardia indexes. It is concluded that, although the first pneumogram does not predict the risk of an adverse outcome in a population of infants with severe apnea of infancy, it does reveal subtle cardiorespiratory differences between study and control infants.
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