Cardiorespiratory events recorded on home monitors - Comparison of healthy infants with those at increased risk for SIDS
Cardiorespiratory events recorded on home monitors - Comparison of healthy infants with those at increased risk for SIDS
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DOI：
10.1001/jama.285.17.2199
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发表时间：
2001-05-02
影响因子：
120.7
通讯作者：
Keens, TG
中科院分区：
文献类型：
--
作者：
Ramanathan, R;Corwin, MJ;Keens, TG
背景设计用于识别心肺事件的家庭监护仪经常用于婴儿猝死综合征（SIDS）风险增加的婴儿，但此类设备用于此用途的有效性尚未得到证实。表观寿命-研究设计：1994年5月至1998年2月进行的一项纵向队列研究。共1079名婴儿（分为健康足月儿和6组SIDS高危儿），在出生后的前6个月，主要结果测量超过预定义的常规和极端阈值的心肺事件的发生率，结果在718 358 h的家庭监护中，445例（41%）婴儿发生了6993次超过常规报警阈值的事件，其中116例（10%）婴儿发生了653次极端事件，其中70%的呼吸暂停事件包括至少3次呼吸阻塞。至少有1个极端事件的频率是相似的，在所有组的足月婴儿，但早产儿的极端事件的风险增加，直到43周的postconceptional age.Conclusions在这项研究中，传统的事件是相当常见的，即使在健康的足月婴儿。极端事件仅在早产儿中常见，其发生时间表明它们不太可能是SIDS的直接前兆。研究参与者呼吸阻塞的频率很高，可能会妨碍通过传统技术检测许多事件。这些数据对于设计未来的监护仪和确定婴儿是否可能有心肺事件的风险非常重要。
Context Home monitors designed to identify cardiorespiratory events are frequently used in infants at increased risk for sudden infant death syndrome (SIDS), but the efficacy of such devices for this use is unproven.Objective To test the hypothesis that preterm infants, siblings of infants who died of SIDS, and infants who have experienced an idiopathic, apparent life-threatening event have a greater risk of cardiorespiratory events than healthy term infants.Design Longitudinal cohort study conducted from May 1994 through February 1998.Setting Five metropolitan medical centers in the United States.Participants A total of 1079 infants (classified as healthy term infants and 6 groups of those at risk for SIDS) who, during the first 6 months after birth, were observed with home cardiorespiratory monitors using respiratory inductance plethysmography to detect apnea and obstructed breathing.Main Outcome Measures Occurrence of cardiorespiratory events that exceeded predefined conventional and extreme thresholds as recorded by the monitors.Results During 718 358 hours of home monitoring, 6993 events exceeding conventional alarm thresholds occurred in 445 infants (41%), Of these, 653 were extreme events in 116 infants (10%), and of those events with apnea, 70% included at least 3 obstructed breaths. The frequency of at least 1 extreme event was similar in term infants in all groups, but preterm infants were at increased risk of extreme events until 43 weeks' postconceptional age.Conclusions In this study, conventional events are quite common, even in healthy term infants. Extreme events were common only in preterm infants, and their timing suggests that they are not likely to be immediate precursors to SIDS. The high frequency of obstructed breathing in study participants would likely preclude detection of many events by conventional techniques. These data should be important for designing future monitors and determining if an infant is likely to be at risk for a cardiorespiratory event.