EVENT RECORDINGS OF HIGH RISK INFANTS ON APNEA MONITORS

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This proposal is designed as part of a multi-center collaborative study on event recordings of high risk infants on apnea monitors. Patients, personnel and facilities are described. These demonstrate the suitability of Kapiolani Medical Center for Women and Children as a site for this study. This proposal will determine the (a) frequency, duration, and type of cardiorespiratory alterations (CRA) based on "true event" monitor alarms in infantile apnea; (b) compliance, and (c) the physiologic and clinical significance of recorded alarm events. The Aequitron 9600 and compatible equipment will be used for home monitoring. The proposed study will evaluate exploratory hypotheses, with appropriate statistical models and tests of significance related to the (1) effect of adverse perinatal events on CRA (2) relation of CRA to the maturational level of the central and autonomic nervous system, (3) effect of enhanced compliance on home event monitoring, (4) home monitoring compliance in different racial/ethnic groups, and (5) the impact of infantile apnea on neurobehavioral development. Study patients will be Caucasian, Hawaiian, and Filipino infants diagnosed with apnea of prematurity and treated with caffeine citrate, infants with ALTE and siblings of SIDS victims. After entry, infants will be assigned to a Home Apnea Monitor Plan, and discharged after apnea is resolved. In addition to "true alarm" recordings, data for the hypotheses will be based on polysomnograms, vagal tone measures, and acoustic cry analyses. The research plan involves a pilot year based on approximately 60 infants and projected follow-up years as well as details related to expansion. Modifications are subject to collaborative and cooperative agreements.