Home monitor follow-up of persistent apnea and bradycardia in preterm infants
C. L. Rosen, D. G. Glaze and J. D. Frost Jr
We reviewed our experience with home monitor observations of 83 preterm
infants (postconceptional age, 36 to 44 weeks) who had persistent apnea,
bradycardia, or cyanosis. Polygraphic recordings before discharge showed
that 92% of these infants had cardiorespiratory abnormalities that included
prolonged (greater than 20 s) apnea, excessive periodic breathing (greater
than 15%), bradycardia (greater than 80 beats per minute), feeding
hypoxemia, or elevated carbon dioxide values. At home, 70 infants had
either no alarms or alarms that resolved spontaneously, while 13 (16%) had
more serious episodes that required parental intervention, including
mouth-to-mouth ventilation in one infant. While polygraphic studies were
helpful in documenting specific cardiorespiratory abnormalities, neither
these abnormalities nor the clinical characteristics of the infants
identified those infants experiencing subsequent home monitor alarms
requiring parental intervention. Our data suggest that some preterm infants
with persistent episodes of apnea, bradycardia, and cyanosis beyond 36
weeks of postconceptional age remain at risk for future serious episodes
for several months.
