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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