Abstract â–¡ 53

Background A number of devices and systems are already available which allow the electronical transmission of physiological parameters from home environment to hospital centers.

Objectives: To evaluate the efficiency and the social implications of two systems of telemedicine:

a) Modern Transmission (MT) of data in infants on home cardiorespiratory monitors;

b) Trans Telephonic Monitoring (TTM) in children with Congenital Central Hypoventilation Syndrome (CCHS-Ondine's Course) and surgically implanted with diaphragm pacemakers.

Study design: a) MT-study: we evaluated compliance data of 74 infants on home monitors with data recorder; 34 were infants with Apparent Life Threatening Events (ALTE), 26 were subsequent siblings of SIDS victims (SS), 12 were former preterm (PT), 2 others. 22 families ( 12 ALTE, 8 SS, 2 PT) had a modern for data transmission.

We divided the infants in two groups: good compliers (more than 8 hours of monitor daily usage) and bad compliers (less than 8 hours of daily usage) b) TTM-study: we reviewed 20 transmissions of phenograms performed from two patients at home and sent to USA referral center (Avery Laboratories-NY)

Results: MT-study showed that 72% of families with modern had a good compliance vs 50% of those without modern (p = 0.005). All the families phoned at least one time to our center to perform a data transmission due to an alarm, but only in one case a true apnea, requiring a tactile stimulation, was found.

TTM-study demonstrated an effective data transmission in 90% of cases, which allowed to reset properly the parameters of pacing (Pulse Interval, Pulse Width, Respiratory Rate, Inspiration Time, Slope) and to discover in one case a receiver malfunction which required the reimplantation of the component.

Conclusions: In MT-study the higher number of the compliers found in the modern group, should be related to a greater awareness during home monitoring. This is a very important goal to achieve, because may deaths during monitoring might be related to a low parental compliance.

TTM-study revealed an efficient method for the management of pacing in babies with CCHS.

Both these systems of telemedicine are indeed cost effective because moving the information rather than the patients reduce Hospital admissions.