Abstract □ 54

Aims: We evaluated the alarm records of home monitors with event recording and parents experience during the home monitoring period.

Patients: 35 infants, 17 male, 18 female; mean gestational age 34 weeks (min 25, max 41), mean birth weight 2180g (min 790g, max 3710g), mean age at discharge with the monitor 43 days (min 4, max 148). The indications for home monitoring were ALTE, symptomatic apnoeas of prematurity and increased risk of SID after intensive care treatment. 14 of them had pathological findings in the polysomnography at discharge and received theophylline.

Methods: Home monitor: Vita Guard 1000™ with alarm recording (Jauck Austria, GeTeMed, Germany). A software package allows the evaluation of the recordings. Curves of ECG, heart rate and breathing movements are visualized on a PC screen. The device also provides a list of technical and patient alarms as well as a compliance graph and provides the date and time of each event. The infants were discharged after the parents had been thoroughly instructed in the handling of the monitor, how to respond to monitor alarms and in infant cardiopulmonary resuscitation. The parents were advised to use the monitor whenever the child slept. At regular visits the recordings were evaluated, alarms were discussed with the parents and reassuring advise was given. If severe events were detected the infant was admitted to hospital. Home monitoring was usually terminated at the age of one year. It was also terminated after 6 months if there had been no patient alarms during the preceding two months. The alarm settings were: apnoea duration of > 14sec, bradycardia < 80 beats/min., tachycardia > 220 beats/min.

Results: The mean duration of home monitoring was 8 months, 8 parents used the monitor until the age of 12 months, in 18 infants the monitoring was terminated after two months without any patient alarm (mean duration 7 months), only in two cases the monitoring was terminated by the parents after one month. Numbers of technical alarms, patient alarms and compliance data were evaluated. Four infants had to be readmitted to the hospital because of monitor alarms. Two suffered from severe apnoea/bradycardias that resolved with a highest dose of theophylline, one infant with bradycardia alarms was diagnosed as an intercurrent pneumonia, and in one case a paroxysmal tachycardia was detected. No ALTE or events that needed resuscitation were reported. 88% of the parents were satisfied with the monitor, only three parents experienced major technical problems. Parents found it reassuring that most of the alarm curves that were shown and discussed had no clinical relevance or were false alarms.

Conclusion: The Vitaguard home monitor with event recording proved to be a safe device that produced reliable alarm recordings. In four infants relevant clinical disorders that needed hospital admission were detected by monitor alarms. Home monitoring with event recording together with an intense counselling program can reassure parents and reduce infant and alarm related concerns.