EVENT RECORDINGS OF HIGH RISK INFANTS ON APNEA MONITORS

在美国，每年有6000到7000名婴儿死于诊断。 婴儿猝死综合症（SIDS） 最有说服力的假设 关于SIDS的病理生理学的研究表明， 突然出现心肺控制异常 努力 防止SIDS死亡的障碍是无法识别婴儿， 事件发生前的风险和对事件的不充分理解 导致终末事件的生理过程。 记录 通过经胸阻抗（TTI）/ECG事件记录进行监测 呼吸和心脏之前、期间和之后的信号 最近已经有了一些变化，并为研究者提供了 这是一个有用的工具，可以用来研究有生命危险的婴儿。 这项研究的具体目的是利用最先进的事件 记录技术，以评估婴儿在增加风险的fife 威胁事件，以1）提高家庭监测的质量，2） 确定监护仪使用中的顺应性，3）获得 心肺功能发作 将建立多中心网络 研究了大约2000名风险增加的患者， 危及生命的事件：有症状性呼吸暂停的早产儿， 出院，婴儿谁经历了明显的危及生命的 没有可识别原因的事件（ALTE），以及随后的兄弟姐妹 婴儿猝死综合症患者。 基线研究将包括红细胞压积、网织红细胞 计数，超声波心动图，颅骨超声，毛发分析 药物、生长参数和神经发育评估。 事件 入院时开始记录TTI/ECG和脉搏血氧饱和度 并持续6个月。 后续实验室 在6和12个月大时的评价将包括血细胞比容， 网织红细胞计数、超声心动图和神经发育评估。 每周与患者联系，每月在门诊进行检查 诊所 将对事件记录进行分析，以确定1）频率， 持续时间和呼吸、心脏和去饱和改变的类型， 2)这些变化的生理意义，3）它们之间的关系 临床结果（异常回声，发育迟缓，生长不良， 和/或死亡），以及4）对监视器使用的依从性。 的结果 研究将证明心肺功能的自然史 风险婴儿的变化，提供了对 心肺机制在危及生命的事件中起作用， 有SIDS风险的婴儿，并改善家庭监护仪的整体使用 对高危婴儿的管理。

Each year between 6000 and 7000 infants in the U.S. die with a diagnosis of sudden infant death syndrome (SIDS). The most compelling hypothesis regarding the pathophysiology of SIDS suggests that infants who die suddenly have abnormalities in cardiorespiratory control. Efforts to prevent SIDS deaths are hampered by an inability to identify infants at risk prior to the event and the inadequate understanding of the physiologic processes leading to the terminal event. Documented monitoring with event recording of transthoracic impedance (TTI)/ECG signals preceding, during, and following respiratory and cardiac alterations has recently become available and provides the investigator with a useful tool to study infants at risk for life-threatening events. The specific aims of this study are to use state of the art event recording technology to evaluate infants at increased risk for fife threatening events in order to 1) improve quality of home monitoring, 2) determine compliance in monitor use, 3) obtain physiologic parameters of cardiorespiratory episodes. A multicenter network will be established to study approximately 2000 patients at increased risk for life-threatening events: preterm infants with symptomatic apnea at discharge, infants who have experienced an apparent life-threatening event (ALTE) without an identifiable cause, and subsequent siblings of SIDS victims. Baseline studies will include hematocrit, reticulocyte count, echocardiogram, cranial ultrasound, hair analysis for illicit drugs, growth parameters, and neurodevelopmental assessment. Event recording with TTI/ECG and pulse oximetry will be initiated on admission to the study and continued for 6 months. Subsequent laboratory evaluation at 6 and 12 months of age will include hematocrit, reticulocyte count, echocardiogram and neurodevelopmental assessment. Patients will be contacted weekly and examined monthly in the outpatient clinic. Event recording will be analyzed to determine 1) the frequency, duration, and type of respiratory, cardiac and desaturation alterations, 2) physiologic significance of these alterations, 3) their relationship to clinical outcome (abnormal echo, developmental delay, poor growth, and/or death), and 4) compliance with monitor use. The results of this study will demonstrate the natural history of cardiorespiratory alterations in at risk infants, provide insight into the cardiorespiratory mechanisms operative in life-threatening events in infants at risk for SIDS, and improve the overall use of home monitors in managing at risk infants.