Abstract
We evaluated the performance of an event recorder system in a large, consecutive series of referred monitored patients to determine the relative incidence of true apnea and true bradycardia, false alarms, and alarms for movement or a loose lead. In addition, we developed an event classification system based on the reason for the event being recorded. The recorder stored transthoracic impedance and electrocardiogram signals on a floppy disk before, during, and after each monitor alarm. These events on 302 disks from 83 patients were analyzed and classified as true, false, or movement-loose lead. Of 14,131 events, only 8% were caused by apnea or bradycardia (true events). Of true events, 70% were triggered by apnea and 30% by bradycardia. These true events occurred in 48% of the patients. False alarms constituted 23%, and movement-loose lead 69%, of all events. Even when movement-loose lead events were excluded, nearly three of four events were found to be false. Event recording proved helpful clinically, allowing discontinuation of the monitor in 49% of patients, modification of monitor alarm settings, or reassurance and counseling for parents.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 702-708 |
| Number of pages | 7 |
| Journal | The Journal of pediatrics |
| Volume | 115 |
| Issue number | 5 PART 1 |
| DOIs | |
| State | Published - Nov 1989 |
Funding
Electronic monitoring of transthoracic impedance and electrocardiogram has been widely used to alert caretakers to impending life-threatening events in infants, as well as in Supported by the Children's Research Guild and the Children's Research Foundation. Presented in part at the American Academy of Pediatrics spring meeting in Orlando, Fla. March 13, 1989. Published in abstract form in Pediatric Research 25:372A, 1989. *Now at Rush-Presbyterian-St. Luke's Medical Center, Rush Medical College, Chicago, Ill. **Now at Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada. ***Now at Medical College Hospital and Teledo Hospital, Medical College of Ohio, Toledo, Ohio. Submitted for publication Mar. 6, 1989; accepted May 24, 1989. Reprint requests: Debra E. Weese-Mayer, MD, Rush Medical College, Rush-Presbyterian-St. Luke's Medical Center, 1653 West Congress Parkway, Chicago, IL 60612. 9/20/14218 the pneumogram assessment of apnea and bradycardia. Thoracic impedance pneumography measures changes in impedance to a small electric current applied across transthoracic electrodes. The thoracic impedance signal fluctuates with the relative proportion of nonconductive air to conductive blood, fluid, and tissue in the pathway of the electric current. 1-3 The National Institutes of Health Consensus Development Conference on Infantile Apnea and Home Monitor-
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health