Failure of conventional monitoring to detect apnea resulting in hypoxemia

Abstract:

Twenty-one preterm infants with recurrent apnea were studied on 43 occasions. In study periods of 2-7 hours we continuously monitored transcutaneous PO2 (tcPO2), blood flow under the electrode, thoracic impedance, and heart rate. In a second series of 15 infants, nasal air flow and fontanel pressure were also monitored. The effect of various forms of apnea on oxygenation is investigated and the effectiveness of conventional respiratory monitors is evaluated. Nurses' records underestimate both frequency and duration of apneas by more than 100%. Bradycardia is an unreliable index of hypoxia. Duration of apnea alone correlates poorly with the development of hypoxemia and impedance alarm failures are frequent. Finally, a 'disorganized pattern of breathing' is described which causes significant hypoxemia but is undetected by conventional monitoring systems.

Año de publicación:

1979

Keywords:

Fuente:

scopus