Predischarge respiratory recordings in very low birth weight newborn infants

Barrington, Keith J.; Finer, Neil N.; Li, Dejuan

doi:10.1016/s0022-3476(96)70044-6

Cited by 50 publications

(30 citation statements)

References 10 publications

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“…This observation suggests that infants with resolving AOP treated with caffeine who have postdischarge complications cannot be identified by GA or birth weight alone. Our results differ from those of Barrington et al, 11 who found no relationship between PDER and adverse outcome. Barrington screened every infant with a birth weight of Ͻ1250 gm, not just those with resolving AOP treated with caffeine.…”

Section: Discussioncontrasting

confidence: 99%

“…We studied only infants with resolving AOP with caffeine, independent of GA or birth weight, and defined significant apnea as an episode lasting for Ն20 seconds, thus describing a subpopulation of that previous report. 11 Our results suggest that infants discharged on caffeine with a normal PDER are functionally more mature than the abnormal group despite a similar corrected GA at discharge.…”

Section: Discussionmentioning

confidence: 57%

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Prediction of Postdischarge Complications by Predischarge Event Recordings in Infants With Apnea of Prematurity

2000

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OBJECTIVE:To determine whether predischarge event recording (PDER) can accurately identify preterm infants with resolving apnea of prematurity (AOP) at risk for postdischarge complications. DESIGN:PDER was performed on infants with resolving AOP on caffeine, ready for discharge. The outcome of infants with normal recordings was compared with that of infants with abnormal recordings. Follow-up data were obtained for outcome. RESULTS:Of the 106 infants, 74 had a normal PDER and 32 had an abnormal PDER (apneas lasting for Ͼ20 seconds and/or a heart rate of Ͻ80 beats per minute for Ͼ5 seconds). Birth weight, gestational age at birth, length of stay, discharge weight, and duration of caffeine treatment after discharge were no different between groups. None of the normal PDER infants (0 of 74) had postdischarge complications, whereas 4 of 32 infants with an abnormal PDER had complications (p Ͻ 0.05, power ϭ 0.7). The positive predictive value of a normal PDER and no postdischarge complications was 100%. The positive predictive value of an abnormal PDER and an adverse outcome was 12.5%. CONCLUSION:Normal PDER accurately identifies infants at low risk for an adverse outcome. Journal of Perinatology 2000; 2:92-95.Apnea of prematurity (AOP) is a common diagnosis in the premature infant, occurring in up to 85% of infants of Ͻ34 weeks' gestation.1 Timing of discharge for infants with AOP in a safe and expedient manner is a challenge faced by many neonatologists. Criteria for discharge of these infants may include an apnea-free interval, 2 usage of medications (methylxanthines), 3,4 gestational age (GA) at birth, or corrected age at discharge.Documented event recording has been used to evaluate the compliance of monitor usage at home 5,6 and to document efficacy of treatment;7,8 in addition, documented event recording has been shown to result in a shorter duration of home monitoring compared with a nonrecording monitor. 9 We use predischarge recordings as a tool for determining the need for home apnea monitoring at hospital discharge.Event-recording apnea monitors record cardiorespiratory waveforms with pulse oximetry; the user sets the parameters that define an event.5-13 For example, in-hospital "test" parameters in our institution record apneas lasting for Ͼ10 seconds and heart rates of Ͻ90 beats per minute. Smith and Hoy 14 reported a positive correlation between an abnormal predischarge event recording (PDER) performed for 1 week and continued apneas at home. We sought to determine whether a 24-hour PDER in preterm infants treated with caffeine could accurately identify infants who are at greater risk of an adverse outcome [15][16][17][18][19][20] (apparent life-threatening event [ALTE], rehospitalization, and death). METHODSThe medical records of all preterm infants followed by the Infant Apnea Program at University Medical Center and Hospital at Stony Brook during the period of January 1, 1996 to January 13, 1999 were reviewed retrospectively. Only those infants discharged with caffeine citrate were included. Informed...

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionmentioning

confidence: 57%

Prediction of Postdischarge Complications by Predischarge Event Recordings in Infants With Apnea of Prematurity

2000

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“…5 An US study by Barrington KJ et al, reported 6-22% incidence of apnea in VLBW neonates. 6 Nimavat DJ et al, from US also reported the incidence of apnea to be 25% in neonates <2500g birth weight, 50% in neonates with <1500g and 84% in neonates with <1000g. 7 Guruprasad et al reported 25% incidence of apnea in VLBW neonates.…”

Section: Discussionmentioning

confidence: 95%

“…Barrington KJ et al, reported that apnea frequently start on first day of life (frequency was highest in first 24 hours after birth with a mean frequency of 0.9 per hour and gradually reduced thereafter, falling to 0.2/Hr by 5 days of age). 6 Smart H et al, reported that apnea commences in first two days of life in 77% of cases and was unlikely to commence after 7 days. 9 HIE being a more contributing factor (25.67%) for apnea in our study, may be the cause of more number of cases developing apnea between 24 to 72 hrs of life in our study as HIE leads to respiratory failure mostly between 24 to 72 hrs.…”

Section: Discussionmentioning

confidence: 99%

A clinical study of incidence and etiology of apnea in newborn

Rajith

2017

Int J Contemp Pediatr

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Background: Apnea, defined as cessation of breathing resulting in pathological changes in heart rate and oxygen saturation, is a common occurrence especially in preterm neonates, apnea is not a disease and is a symptom of various diseases that affect neonates. Aim was to know the incidence and etiology of apnea in newborn in Indian setup.Methods: All admitted neonates who developed apnea is documented to know the incidence and selected cases were retrospectively studied to know the etiology.Results: Incidence of apnea was 19.92%, hypoxic ischaemic encephalopathy and sepsis 25.67% each were the common etiologies.Conclusions: Occurrence of apnea definitely reflects the mortality rate in newborns. Incidence of apnea in general and apnea in term newborns in particular are significantly more in comparison with western data. The association of HIE and Sepsis, the potentially preventable causes, perpetuates the incidence of term apnea reflecting the bad obstetric care, poor infrastructure, illiteracy, poor health seeking behavior affecting the child health antenataly, nataly and post nataly. Incidence of apnea in premature newborns is almost comparable to western studies. The primary apnea which is the most common cause, is an uncontrollable entity affecting similarly the newborn community of developed and developing world. India’s taboo of having high infant mortality is once again reflected in the study.

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“…These events, usually termed 'apnoea', become less clinically apparent by 36 weeks postmenstrual age (PMA) although a degree of apnoea persists to discharge [2][3][4]. For a small proportion of infants, persistent apnoea may delay hospital discharge usually because of concerns regarding associated cyanosis or the need for resuscitation [5].…”

Section: Introductionmentioning

confidence: 99%