Cardiorespiratory events recorded on home monitors: Comparison of healthy infants with those at increased risk for SIDS.
R Ramanathan,Michael J. Corwin,Carl E. Hunt,George Lister,Larry R. Tinsley,Terry M. Baird,Jean M. Silvestri,David H. Crowell,D Hufford,Richard John Martin,Michael R. Neuman,Michael R. Neuman,Debra E. Weese-Mayer,L A Cupples,Mark Peucker,Marian Willinger,Thomas G. Keens +16 more
TLDR
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.Abstract:
ContextHome 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.ObjectiveTo 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.DesignLongitudinal cohort study conducted from May 1994 through February 1998.SettingFive metropolitan medical centers in the United States.ParticipantsA 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 MeasuresOccurrence of cardiorespiratory events that exceeded predefined conventional
and extreme thresholds as recorded by the monitors.ResultsDuring 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.ConclusionsIn 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.read more
Citations
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Journal ArticleDOI
Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events
Richard B. Berry,Rohit Budhiraja,Daniel J. Gottlieb,David Gozal,Conrad Iber,Vishesh K. Kapur,Carole L. Marcus,Reena Mehra,Sairam Parthasarathy,Stuart F. Quan,Susan Redline,Kingman P. Strohl,Sally L. Davidson Ward,Michelle M. Tangredi +13 more
TL;DR: The task force made recommendations concerning recommended and alternative sensors for the detection of apnea and hypopnea to be used during diagnostic and positive airway pressure (PAP) titration polysomnography, and recommended scoring rules.
Journal ArticleDOI
“Late-Preterm” Infants: A Population at Risk
TL;DR: The characteristics of late-preterm infants are presented, a change in terminology from “near term” to “late preterm,” and guidelines for the evaluation and management of these infants after birth are proposed.
Journal ArticleDOI
Optimizing Care and Outcome for Late-Preterm (Near-Term) Infants: A Summary of the Workshop Sponsored by the National Institute of Child Health and Human Development
TL;DR: A multidisciplinary team of experts invited to a workshop in July 2005 discussed the definition and terminology, epidemiology, etiology, biology of maturation, clinical care, surveillance, and public health aspects of late-preterm infants, and knowledge gaps were identified.
Journal ArticleDOI
The changing concept of sudden infant death syndrome: Diagnostic coding shifts, controversies regarding the sleeping environment, and new variables to consider in reducing risk
John Kattwinkel,Fern R. Hauck,Maurice E. Keenan,Michael H. Malloy,Rachel Y. Moon,Marian Willinger,James Couto +6 more
TL;DR: Since the AAP published its last statement on SIDS in 2000, several issues have become relevant, including the significant risk of side sleeping position; the AAP no longer recognizes side sleeping as a reasonable alternative to fully supine sleeping.
Journal ArticleDOI
SIDS and Other Sleep-Related Infant Deaths: Expansion of Recommendations for a Safe Infant Sleeping Environment
TL;DR: Recommendations include supine positioning, use of a firm sleep surface, breastfeeding, room-sharing without bed-sharing, routine immunizations, consideration of using a pacifier, and avoidance of soft bedding, overheating, and exposure to tobacco smoke, alcohol, and illicit drugs.
References
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