[The sudden infant death syndrome. II. Its prevention by home monitoring]

Sudden infant death syndrome (SIDS) is a very dramatic situation with a very high incidence rate. Children with a high risk of SIDS can be identified by clinical/epidemiological scorings. The preventive usefulness of home monitoring is now a matter of study. Our experience is reported in this article. Thirty-nine infants at high risk were selected, although the monitoring program was finally achieved in only 36 cases. A cardiorespiratory impedance monitor (Centurion, Clinical Data, Boston, USA) was used. The tachycardia alarm was set at 200 b/min, bradycardia at 60 b/min and apnea > 20 seconds. The parents were trained in running the monitor and received technical support by phone during 24 hour per day. They filled out a daily record sheet with the observed anomalies. The mean time of monitoring was 8.2 months. After the withdrawal of the monitor, the parents answered a form with 26 questions. Twenty-four of the children needed, at least at some occasion, a light stimulation and 12 (33.3%) required a strong one. Meanwhile, the other 12 did not need any type of stimulus during monitoring. A simultaneous apnea/bradycardia alarm occurred in 17 cases. The home monitoring program was considered positive by the parents and only 4 families had technical difficulties. After the second week the fear and anxiety disappeared and only 1 family continued to be nervous throughout the monitoring program. The mean number of false alarms was 13.3/child, as opposed to 15.6 alarms due to apnea, 11.6 due to tachycardia and 0.9 due to apnea plus bradycardia. In conclusion, we think that home monitoring is easy, it reassures the families and their acceptance of the program is good.