MONITORING STUDIES IN OLDER PRETERM INFANTS WITH PERSISTENT APNEA

Abstract

Fifteen preterm infants (PC ages 36-42 weeks), with persistent apnea, bradycardia, and/or cyanosis, but otherwise normal, were monitored within a 2 week period using 3 methods: 1) pneumogram (PG), 12-hour recording of chest impedance changes and EKG; 2) oxycardiorespirogram (OCR), 4-hour recording of tcO2, impedance pneumography and EKG; 3) polygraphic sleep studies (PS), 6-12 hour recording of 11 parameters including EEG, tcO2, respiratory movements, ETCO2, and EKG. Abnormalities were identified in all 15 infants: 13 by PS, 10 by PG, 9 by OCR. The following abnormalities were recorded: prolonged apnea (PA), excessive periodic breathing (PB), bradycardia (B), disorganized breathing (DB), increased mixed and obstructive pauses (M/O), and hypoxemia during feeding (HF): During PS elevated CO2 occurred in 10 infants. All were discharged on home monitors: 9 had subsequent apnea or bradycardia alarms that self-corrected; 3 had events requiring stimulation but not CPR. Only one infant with prolonged apnea by PS had an alarm requiring intervention. No single finding predicted risk for subsequent serious episodes. Our data suggest that monitoring studies are helpful in characterizing cardiorespiratory abnormalities in these infants and that PS may document abnormalities not recognized during PG or OCR.