Abstract â–¡ 60

In two patients, born prematurely at the postmenstrual age of respectively 25 and 28 weeks, with ventriculoperitoneal drainage for posthaemorraghic hydrocephalus, cardiorespiratory home monitoring was started after polysomnography had showed important bradycardias. Both patients had regular periods of severe bradycardias (i.e. heart rate < 50/minute) during the first two years, which were linked to periods of upper and lower airway infections. In the first patient a revision of the drain was needed at the age of 18 and 25 months, in the second patient at the age of 18 months. At the hospital the patients presented with classical symptoms i.e. lethargy or irritability and vomiting. In the days preceding these events; the parents reported an increase in frequency of alarms, while the infants did not show any signs of airway infections. Outprint of these alarms showed important bradycardias in the week before the acute event happened. For both parents, this was the first important symptom before clinical symptoms became evident.

Important bradycardias on home monitoring were in two patients the first signs of intracranial hypertension due to a dysfunctional ventriculoperitoneal drainage. Other causes for a increasing frequency of bradycardias were upper and lower respiratory infections due to obstructive apnea.