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INDICATIONS FOR MONITORING

The use of apnea monitors decreases mortality in high-risk infants. There are no indisputable indications for the use of monitors in neonates. We suggest to send the following neonates home on apnea monitors: (1) those with an apparent or confirmed life-threatening episode if the etiology is unknown, unresolved, or likely to recur; (2) those with a sibling who died of sudden infant death syndrome; (3) premature neonates with persistent apnea at the time of discharge; and (4) those who go home on respiratory stimulants, medications for gastroesophageal reflux, oxygen for chronic lung disease, or with a tracheostomy. The use of monitors for premature neonates without apnea or with few apneic episodes shortly after birth is controversial. Some neurologists believe that all premature neonates should go home on a monitor while others believe that if no apnea occurs for 1 week prior to discharge they should go home without a monitor. The latter position is supported by a consensus statement from the National Institutes of Health.

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Gibson, 1996 Consensus development panel, 1987