EVENT RECORDINGS OF HIGH RISK INFANTS ON APNEA MONITORS

事件记录式心肺监护仪可能会增加一个重要的新功能， 婴儿呼吸暂停的管理技术。 适当使用 这些监测器尚未确定。 本研究的目的是（1） 确定呼吸和心脏的频率，持续时间和类型 在有生命威胁事件风险的婴儿中观察到的模式，（2） 确定患者对家庭监测的依从性，以及（3）获得 记录的生理和临床意义的信息 警报事件。 此外，我们将测试假设：（1）记录 事件记录监视器可以更好地管理 婴儿比父母报警报告，（2）事件记录监视器 检测多导睡眠图研究中观察到的所有事件，（3）阻塞性 呼吸暂停见于有SIDS风险的婴儿，以及（4）事件记录 监测员将提供更好的数据，以确定何时可以进行监测， 停止了。 生物物理学和人口统计学数据将从 以下风险群体中的婴儿样本：（1）前早产儿 婴儿，（2）死于SIDS的婴儿的后续兄弟姐妹，以及（3） 发生急性危及生命事件（ALTE）的婴儿。 所有 婴儿将收到包括脉搏在内的事件记录家庭监视器 将受试者随机分为两组： 世卫组织的护理人员将仅根据监视器警报报告事件， 那些将为他们的医生提供完全访问记录的 事件 协议将确定是否存在差异， 结果测量：（1）SIDS，（2）ALTE，（3）进一步医疗干预 （4）年龄，当监测停止，和（5）复发。 婴儿 将在家中监测约6个月，并定期 回访以重复多导睡眠图研究。 的有用性 这些多导睡眠图将通过比较这些 测试结果。 监视器记录的事件将 进行分析，以确定这些婴儿是否有一个或多个阳性 结果测量显示与正常不同的事件模式。 家 在医院多导睡眠图期间将使用监测设备 确定事件敏感性和特异性的研究 检测算法，并且虚警率将从 事件记录。 用于测试监视器和 评估阻塞性呼吸暂停将与 NCRR支持CWRU生物医学传感器技术资源。

Event-recording cardio-respiratory monitors may add a significant new technology for the management of infant apnea. The appropriate use of these monitors has yet to be defined. The goals of this study are to (1) determine the frequency, duration, and type of respiratory and cardiac patterns seen in infants at risk for a life threatening event, (2) determine patient compliance with home monitoring, and (3) obtain information on the physiologic and clinical significance of recorded alarm events. In addition, we will test the hypotheses: (1) recording of events by an event-recording monitor results in better management of infants than parental reporting of alarms, (2) event-recording monitors detect all events seen within polysomnographic studies, (3) obstructive apnea is seen in infants at risk for SIDS, and (4) event-recording monitors will provide better data to determine when monitoring can be discontinued. Biophysical and demographic data will be collected from a sample of infants in the following risk groups: (1) former premature infants, (2) subsequent siblings of infants who died of SIDS, and (3) infants who have experienced an acute life threatening event (ALTE). All infants will receive event-recording home monitors including a pulse oximeter, and subjects will be randomized into two equal groups: those who's caregivers will report events based only on monitor alarms, and those who will provide their physician with full access to recorded events. The protocol will determine whether there is a difference in the outcome measures of: (1) SIDS, (2) ALTE, (3) further medical intervention required, (4) age when monitor is discontinued, and (5) relapse. Infants will be monitored at home for approximately 6 months and have regular return visits for repeat polysomnographic studies. The usefulness of these polysomnograms will be evaluated by comparing the results of these tests with the outcome measures. Recorded events from the monitors will be analyzed to determine if those infants with one of more positive outcome measures display different patterns of events from normals. Home monitoring devices will be used during the in-hospital polysomnographic studies to determine the sensitivity and specificity of the event detection algorithm, and the false alarm rate will be determined from the event recordings. Special instrumentation used for testing monitors and evaluating obstructive apnea will be developed in conjunction with the NCRR supported CWRU Resource on Biomedical Sensor Technology.