Abstract □ 62

The etiopathogenesis of SIDS is not exactly known until today and therefore the prevention is very important. Since 1991 on the base of our knowledge and possibilities we gradually built complex approach. Very important matter is polysomnographic examination of children with ALTE and their home monitoring by apnoe monitors.

In the period since May 1994 till August 1998, 79 children until one year of life who suffered from ALTE were given apnoe monitors for home monitoring. The average age for beginning of monitoring was 2,4 month. All babies were examined by polysomnography. During the sleep in some children we have registered various disorders of breathing (in Stud. pneumol. phtiseol., 1997). Slovak SIDS Foundation has render free of charge an apnoe monitor to all children. All parents were instructed in resuscitation and algorithm since alarm start. All our disposal we had totally 23 non-contact apnoe monitors (Baby Sense, Sanesco - Israel). The average time of monitoring was 7,8 month (shortest 4,6 month, longest 2,4 years). There was not recorded any technical breakdown of apnoe monitors. During the followed period at 7 children we observed nine severe ALTE events. These children were resuscitated and admitted to hospital.

At the cost of 190 $ for one apnoe monitor the cost/benefit is very profitable not only because of price, but most of all because of saving lives of those children and also in prevention after effects of hypoxiae of CNS (psychomotoric retardation, cerebral palsy and more frequent morbidity. Authors describe indications for home-monitoring and algorithm of procedures after alarm, possible psychological consequences and reasons for finishing of home-monitoring.

Four year period of home-monitoring of babies with ALTE has a positive results because recently we record a continual decrease of SIDS rate in nation-wide scale (in 1994 the SIDS incidence was 0,55/1000, in 1996 it was 0,16/1000 and in 1997 the SIDS rate was only 0,14/1000).