Margin of safety for discharge after apnea in preterm infants
Margin of safety for discharge after apnea in preterm infants
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DOI：
10.1542/peds.100.5.795
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发表时间：
1997-11-01
期刊：
影响因子：
8
通讯作者：
Robinson, M
中科院分区：
文献类型：
--
作者：
Darnall, RA;Kattwinkel, J;Robinson, M
目标。大多数新生儿科医生在早产儿出院的标准中包括无呼吸暂停期。然而，在没有监护的情况下将婴儿送回家之前，在呼吸暂停停止后应该等待多长时间是有争议的。我们进行这项研究的目的是试图确定从最后一次呼吸暂停发作到出院之间的最短和安全的观察期。我们推断，在早产儿特发性呼吸暂停的婴儿中，呼吸暂停发生的天数间隔逐渐增加，直到临床意义上的呼吸暂停停止的某一点。因此，了解在最后一次呼吸暂停之前发生呼吸暂停的天数间隔将为最后一次呼吸暂停和出院之间的最小安全观察间隔提供合理的估计。我们回顾了1993年和1994年出生的266名胎龄小于或等于32周或体重小于或等于1500克的婴儿的图表，以确定最后一次呼吸暂停发生的日期和前两天发生呼吸暂停的时间间隔。175名婴儿被排除在外因为他们从来没有经历过呼吸暂停，或者缺少最后一次呼吸暂停的数据，或者他们在呼吸暂停的最后3天里服用了黄嘌呤，或者他们称重了
Objective. Most neonatologists include an apnea-free period in the criteria for the discharge of preterm infants. However, the length of time one should wait after the cessation of apnea before sending an infant home without a monitor is debated. We undertook this study in an attempt to define a minimal and safe observation period between the time of the last apnea episode and discharge.Methods. We reasoned that in infants with idiopathic apnea of prematurity, the intervals between days on which apnea occurs gradually increase until some point at which clinically significant apnea ceases. Therefore, knowledge about the intervals between days on which apnea occurred just before the last apnea would provide a reasonable estimate of the minimal safe observation interval between the last apnea and discharge. We reviewed the charts of 266 infants born in 1993 and 1994 at less than or equal to 32 weeks' gestational age or weighing less than or equal to 1500 g at birth from two institutions to determine the intervals between the day on which the last apnea occurred and the previous two days on which apnea occurred. One hundred seventy-five infants were excluded because they never experienced apnea, or data about the last apnea was missing, or they were on xanthines during the period encompassing the last 3 apnea days, or they weighed