EVENT RECORDINGS OF HIGH RISK INFANTS ON APNEA MONITORS

呼吸暂停监测仪上高危婴儿的事件记录

• 批准号: 3567067
• 负责人: DEBRA ELLYN WEESE-MAYER
• 金额: $ 32.25万
• 依托单位: LURIE CHILDREN'S HOSPITAL OF CHICAGO
• 依托单位国家: 美国
• 财政年份: 1991
• 资助国家: 美国
• 起止时间: 1991-09-30 至 1996-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/3567067
• 关键词: apnea; blood cell count; bradycardia; cooperative study; developmental neurobiology; disease /disorder proneness /risk; echocardiography; heart function; home health care; human subject; infant human (0-1 year); longitudinal human study; neuropsychological tests; oximetry; patient monitoring device; premature infant human; respiratory function; siblings; sudden infant death syndrome; therapy compliance; ultrasonography

Each year between 6000 and 7000 infants in the U.S. die with a diagnosis of sudden infant death syndrome (SIDS). The most compelling hypothesis regarding the pathophysiology of SIDS suggests that infants who die suddenly have abnormalities in cardiorespiratory control. Efforts to prevent SIDS deaths are hampered by an inability to identify infants at risk prior to the event and the inadequate understanding of the physiologic processes leading to the terminal event. Documented monitoring with event recording of transthoracic impedance (TTI)/ECG signals preceding, during, and following respiratory and cardiac alterations has recently become available and provides the investigator with a useful tool to study infants at risk for life-threatening events. The specific aims of this study are to use state of the art event recording technology to evaluate infants at increased risk for fife threatening events in order to 1) improve quality of home monitoring, 2) determine compliance in monitor use, 3) obtain physiologic parameters of cardiorespiratory episodes. A multicenter network will be established to study approximately 2000 patients at increased risk for life-threatening events: preterm infants with symptomatic apnea at discharge, infants who have experienced an apparent life-threatening event (ALTE) without an identifiable cause, and subsequent siblings of SIDS victims. Baseline studies will include hematocrit, reticulocyte count, echocardiogram, cranial ultrasound, hair analysis for illicit drugs, growth parameters, and neurodevelopmental assessment. Event recording with TTI/ECG and pulse oximetry will be initiated on admission to the study and continued for 6 months. Subsequent laboratory evaluation at 6 and 12 months of age will include hematocrit, reticulocyte count, echocardiogram and neurodevelopmental assessment. Patients will be contacted weekly and examined monthly in the outpatient clinic. Event recording will be analyzed to determine 1) the frequency, duration, and type of respiratory, cardiac and desaturation alterations, 2) physiologic significance of these alterations, 3) their relationship to clinical outcome (abnormal echo, developmental delay, poor growth, and/or death), and 4) compliance with monitor use. The results of this study will demonstrate the natural history of cardiorespiratory alterations in at risk infants, provide insight into the cardiorespiratory mechanisms operative in life-threatening events in infants at risk for SIDS, and improve the overall use of home monitors in managing at risk infants.

美国每年有6000至7000名婴儿死于诊断 猝死综合征（SIDS）。 最引人注目的假设 关于小儿小伙子的病理生理学表明死亡的婴儿 突然在心肺控制方面存在异常。 努力 防止小岛屿发展中国家的死亡受到无法识别婴儿的阻碍 事件之前的风险和对 生理过程导致终端事件。 记录 通过经胸腺阻抗（TTI）/ECG的事件记录进行监测 在呼吸和心脏之后的信号 更改最近已可用，并为调查员提供了 使用有用的工具来研究有威胁生命事件的婴儿的婴儿。 这项研究的具体目的是使用最先进的事件 记录技术以评估有法夫风险增加的婴儿 威胁事件以至1）提高家庭监控质量，2） 确定监视器使用中的合规性，3）获取生理参数 心肺发作。 将建立一个多中心网络 研究大约有2000名患者的风险增加 威胁生命的事件：有症状呼吸暂停的早产儿 出院，经历了明显威胁生命的婴儿 事件（Alte）没有可识别的原因，随后的兄弟姐妹 席德受害者。 基线研究将包括血细胞比容，网状细胞 计数，超声心动图，颅骨超声，非法的头发分析 药物，生长参数和神经发育评估。 事件 使用TTI/ECG和脉搏血氧仪记录将在入院时启动 进行研究并持续6个月。 随后的实验室 6个月和12个月时的评估将包括血细胞比容， 网状细胞计数，超声心动图和神经发育评估。 将每周联系患者，并每月在门诊病人中进行检查 诊所。 将分析事件记录以确定1）频率， 呼吸，心脏和去饱和的持续时间和类型， 2）这些改变的生理意义，3）它们的关系 临床结果（异常回声，发育延迟，增长差， 和/或死亡），以及4）遵守监视器的使用。 结果的结果 研究将证明心肺的自然史 危险婴儿的改变，提供对 心肺机制在威胁生命的事件中起作用 有小岛屿发展中国家风险的婴儿，并改善家庭监测器的整体使用 在危险中管理婴儿。