title: Short-term event recording as a measure to rule out false alarms and to shorten the duration of home monitoring in infants.
abstract: Apnea and cardiorespiratory home monitors are commonly used for electronic surveillance of infants. Frequent alarms can be very stressful for parents and lead to unnecessarily prolonged home monitoring. The aims of this study were to determine the frequency and type of significant events by using short-term home event recordings of respiratory, electrocardiogram and oxygenation patterns, to consider the pros and cons of oxygenation recording, to correlate the findings with observations made by parents and to find out whether parents could be reassured by the use of these monitors. We investigated recordings from 26 healthy symptomless infants (14 male, 12 female) whose parents experienced anxiety and stress owing to frequent alarms on their apnea (n = 2) or cardiorespiratory home monitors (n = 24). 770 events were analyzed and compared with the parents' interpretation. Median duration of monitoring was 10 days. Only 39/770 alarms (5.1%) were classified as true alarms. Of these, 30 alarms (76.9%) were misinterpreted as false alarms by parents. In contrast, of 218 alarms regarded as true by parents only 15 (6.9%) were in fact true, alarms. The comparison of monitor data and the parents' reports showed no correlation in interpretation of alarms, for both true (r = 0.06) and false alarms (r = -0.09). Of 283 oxygenation alarms, only two were due to real desaturation. Following short-term monitoring, 21/26 parents (80.7%) declared they were reassured. Monitoring could immediately be discontinued in 17/26 infants (65.4%). Short-term event recording can clarify the significance of frequent alarms, reassure parents and shorten the duration of home monitoring.
authors.affiliation: Department of Pediatrics, University of Graz, Graz, Austria. heinz.zotter@klinikum-graz.at
authors.forename: Heinz
authors.initials: H
authors.lastname: Zotter
authors.forename: Renate
authors.initials: R
authors.lastname: Schenkeli
authors.forename: Ronald
authors.initials: R
authors.lastname: Kurz
authors.forename: Reinhold
authors.initials: R
authors.lastname: Kerbl
mesh_terms: D017281:Cost of Illness; D004868:Equipment Failure; D005189:False Positive Reactions; D005260:Female; D006701:Home Nursing / Q000379:methods* / Q000523:psychology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010092:Oximetry / Q000295:instrumentation; D010290:Parents / Q000523:psychology; D017286:Polysomnography / Q000295:instrumentation* / Q000523:psychology; D015203:Reproducibility of Results; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000517:prevention & control* / Q000523:psychology