EVENT RECORDINGS OF HIGH RISK INFANTS ON APNEA MONITORS

事件记录心肺监护仪可能会增加一个重要的新 管理婴儿呼吸暂停的技术。适当地使用 这些监视器还没有定义。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 有生命危险的婴儿的模式，(2) 确定患者对家庭监护的遵从性，以及(3)获得 关于记录的生理和临床意义的信息 警报事件。此外，我们还将检验假设：(1)记录 事件记录监控器的事件可实现更好的管理 婴儿比父母报告警报，(2)事件记录监视器 检测多导睡眠图检查中看到的所有事件，(3)梗阻 呼吸暂停见于有婴儿呼吸窘迫综合征风险的婴儿，以及(4)事件记录 监视器将提供更好的数据来确定何时可以进行监视 停产。生物物理和人口统计数据将从一个 以下风险组的婴儿样本：(1)早产儿 婴儿，(2)死于小岛屿发展中国家的婴儿的后续兄弟姐妹，以及(3) 经历过急性生命威胁事件(ALTE)的婴儿。全 婴儿将接受包括脉搏在内的事件记录家庭监测器 血氧计，受试者将被随机分成两组： 世卫组织的护理人员将仅根据监视器警报报告事件，以及 那些将为他们的医生提供完全访问记录的人 事件。协议将确定是否存在差异 结果衡量：(1)小岛屿发展中国家，(2)Alte，(3)进一步的医疗干预 需要，(4)停止使用监护仪的年龄，以及(5)复发。婴儿 将在家中接受大约6个月的监测，并定期 重复多导睡眠图检查的回访。的用处 这些多导睡眠图将通过比较以下各项的结果进行评估 使用结果测量进行测试。从监视器记录的事件将 被分析以确定这些婴儿是否有一个或多个阳性 结果衡量标准显示出与正常情况不同的事件模式。家 在住院期间进行多导睡眠监测时将使用监护设备 研究以确定事件的敏感性和特异性 检测算法，虚警率将从 活动录音。用于测试监视器和 评估阻塞性呼吸暂停将与 NCRR支持CWRU关于生物医学传感器技术的资源。

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.