This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow P3Rs: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when P3Rs are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Di Fiore, J. M.
Right arrow Articles by Martin, R. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Di Fiore, J. M.
Right arrow Articles by Martin, R. J.
Related Collections
Right arrow Premature & Newborn

PEDIATRICS Vol. 108 No. 6 December 2001, pp. 1304-1308

Cardiorespiratory Events in Preterm Infants Referred for Apnea Monitoring Studies

Juliann M. Di Fiore, BSEE, Marina K. Arko, RN, BSN, Martha J. Miller, MD, PhD, Abby Krauss, Anupama Betkerur, Arlene Zadell, RN, BSN, Sarah R. Kenney, MD and Richard J. Martin, MD

From the Division of Neonatology, Department of Pediatrics, Rainbow Babies and Children’s Hospital, Case Western Reserve University, Cleveland, Ohio

Background. Episodes of apnea, desaturation, and bradycardia are common in preterm infants. Such infants who have persistent cardiorespiratory events detected by clinical bedside monitoring often are referred for overnight apnea monitoring studies.

Objective. To characterize apnea, bradycardia, and desaturation events in infants referred for an overnight apnea monitoring study and compare them with corresponding events in control infants of similar age and weight with no bedside monitor alarms.

Methods. Twelve-hour bedside apnea monitoring studies were performed on 68 preterm infants before hospital discharge. This population included 35 infants who were referred by their attending physicians because of persistent bedside monitor alarms (referral group) and 33 infants who had no documented cardiorespiratory events for at least 2 days before the study (control group). Each study monitored respiration via respiratory inductance plethysmography, oxygen saturation (Sao2), and heart rate. Events were defined as meeting 1 of the following criteria: apnea >=20 seconds, bradycardia <=80 beats per minute, or Sao2 <=80%.

Results. The incidence of apnea >=20 seconds was low, with no significant difference between infant groups. Referral infants exhibited a higher occurrence of desaturation episodes (20 ± 6 vs 6 ± 3 episodes/12-hour study) and a higher occurrence of bradycardia episodes (4.3 ± 0.8 vs 1.1 ± 0.3 episodes/12-hour study) than controls. These episodes of desaturation and bradycardia were always preceded by a respiratory pause, which was shorter in the referral infants (10.0 ± 0.4 seconds vs 12.0 ± 1.0 seconds). Baseline Sao2 was lower in referrals than controls (95 ± 1% vs 98 ± 1%), and the incidence of periodic breathing was significantly higher.

Conclusions. Infants referred for apnea monitoring studies because of persistent bedside monitor alarms have very infrequent prolonged apnea but a higher frequency of desaturation and bradycardia in response to short respiratory pauses than infants without persistent bedside monitor alarms. Referral infants also exhibit a lower baseline Sao2. These abnormalities in oxygenation and cardiorespiratory control may be markers for subtle residual lung disease or functional central nervous system abnormalities.

Key Words: apnea • bradycardia • oxygen saturation

Abbreviations: RIP, respiratory inductance plethysmography • Sao2, oxygen saturation

Received for publication Feb 22, 2001; Accepted Jun 15, 2001.




This article has been cited by other articles:


Home page
 PediatricsHome page
J. M. Di Fiore, M. Arko, M. Whitehouse, A. Kimball, and R. J. Martin
Apnea Is Not Prolonged by Acid Gastroesophageal Reflux in Preterm Infants
Pediatrics, November 1, 2005; 116(5): 1059 - 1063.
[Abstract] [Full Text] [PDF]

Home page
 NeoReviewsHome page
T. M. Baird, R. J. Martin, and J. M. Abu-Shaweesh
Clinical Associations, Treatment, and Outcome of Apnea of Prematurity
NeoReviews, April 1, 2002; 3(4): e66 - 70.
[Full Text] [PDF]