Incidence and Parental Perception of Home Cardiorespiratory Monitor Use in Preterm Infants

Abstract Background: Achievement of physiological stability is essential for safe hospital discharge of a premature infant. While there is no scientific evidence that use of home cardiorespiratory (CR) monitoring decreases the incidence of Sudden Infant Death Syndrome (SIDS), the impact on the length of hospitalization and on parents’ experience has not been described in the literature. Methods: A retrospective patients record review was conducted to assess CR monitor use at discharge in preterm infants born at The University of Kansas Health System (TUKHS) from January 1, 2016, to December 31, 2017. Full-term infants, infants with a family history of SIDS, preterm infants discharged home on oxygen and those with major congenital/chromosomal anomalies were excluded. Data were collected on patient demographics, caffeine prescription, hospital readmission within 30-days of discharge and median length of stay (LOS). Eligible participants received a telephone survey administered by a research assistant post-discharge that examined parents’ CR monitor experiences and use. Results: Over the 2-year study period, forty-four infants were discharged home on CR monitor with the incidence of 8.1%. Of these, eight (18.2%) preterm infants were discharged home on caffeine for apnea of prematurity. Only four readmissions were noted within 30-days of discharge; one infant was readmitted due to bradycardia spells observed on CR monitor (2.8%). Total 28 responses out of 44 were received at the follow up telephone survey (63.6%). Most parents reported feeling secure (67.8%) but anxious (60.7%) using the CR monitor. Parents who reported experiencing false alarms frequently also reported having feelings of anxiety while using the CR monitor (χ² =5.1, p = 0.02). Conclusion: Readmissions due to false alarms while using CR monitors at home for preterm infants were rare in our cohort. Many parents reported feeling anxious in presence of frequent false alarms when using the monitor as prescribed by the neonatologists. Providers should monitor parental feelings of anxiety and provide interventions as needed