Related Experiment Videos
Frequency and timing of recurrent events in infants using home cardiorespiratory monitors
A Côté1, C Hum, R T Brouillette
1Jeremy Rill Center for SIDS and Respiratory Control Disorders, Quebec, Canada.
Insights
Most infant cardiorespiratory events, including apnea and bradycardia, occur within the first month of home monitoring. Vigilant follow-up is crucial for infants using these devices to predict and manage recurrent events.
Area of Science:
- Pediatrics
- Cardiology
- Neonatology
Background:
- Home cardiorespiratory monitoring is used for infants at risk of significant clinical events.
- Understanding the patterns of recurrent events is vital for effective management.
Purpose of the Study:
- To determine the incidence, type, timing, and predictive factors of recurrent significant events in infants using home cardiorespiratory monitors.
Main Methods:
- A retrospective review of 147 infants using event-recorder type monitors.
- Infants were categorized into four groups: apparent life-threatening events (ALTE), former premature infants with apnea/bradycardia, SIDS siblings, and parental anxiety.
Main Results:
- 36% of infants experienced significant events, with 87% of first events occurring in the first month of monitoring.
- Bradycardic events were most prevalent.
- Events recorded during initial hospital investigation predicted recurrence at home (p < 0.001).
Conclusions:
- The majority of apnea, bradycardia, and recurrent events initiate within the first month of home monitoring.
- Close follow-up is essential immediately after initiating home monitoring.
- Readmission for investigation is recommended for infants with severe or multiple recurrent events.
Objective:
To determine the incidence, type, timing, and factors predictive of recurrent significant events in infants with home cardiorespiratory monitors.
Study Design:
We reviewed data accumulated for 147 patients with an event-recorder type of monitor. The infants were allocated to one of four diagnostic categories: apparent life-threatening events (ALTE, n = 73), former premature infants with persistent apnea and bradycardia (n = 29), siblings of victims of sudden infant death syndrome (SIDS) (n = 24), and parental anxiety after a nonsignificant event (n = 21).
Results:
Compliance with monitoring was excellent; the monitors were used on 94% of the prescribed days. Fifty-three (36%) of 147 infants had significant events; of those, 46 (87%) experienced their first event during the first month of monitoring, and 69% of the events occurred during that first month. The most prevalent event type was a bradycardic event. Among infants in the ALTE group, events during the initial investigation period predicted the likelihood of events at home; 2 of the 47 infants (4%) with negative results for an investigation and no events recorded in hospital had apnea, and 4 had a bradycardic event (9%). In contrast, when significant events were recorded in hospital, the events were likely to recur at home (69% and 35% of the infants had apnea or bradycardia, respectively; p < 0.001).
Conclusion:
Because most apnea, bradycardia, and recurrent clinical events began during the first month of monitoring, we emphasize the need for vigilant follow-up care of infants immediately after institution of home monitoring. Readmission for investigation is warranted in infants with severe or multiple recurrent events.