Silvestri J M, Hufford D R, Durham J, Pearsall S M, Oess M A, Weese-Mayer D E, Hunt C E, Levenson S M, Corwin M J
Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA.
J Pediatr. 1995 Sep;127(3):384-8. doi: 10.1016/s0022-3476(95)70068-4.
Documented monitoring was used to evaluate prospectively (1) the level of compliance among infants in whom cardiorespiratory monitoring was clinically indicated and (2) factors that might influence compliance: diagnosis, socioeconomic status, maternal age and education, and alarms.
Sixty-seven infants (51% female, 49% term) were sequentially enrolled, and monitoring was prescribed for the following indications: siblings of sudden infant death syndrome victims (16%), apnea of prematurity (45%), and apparent life-threatening events or apnea of infancy (39%). Demographic data, alarm and event data, and a summary report of monitor use from the first monitor download were obtained.
Maternal age, education, and insurance status did not differ significantly by indication for monitoring. The median number of monitor alarms per 10 hours of use was 0.7 for apnea or bradycardia and 0.6 for loose lead alarms. Monitors were available for use in the home from 2 to 106 days (median, 11 days). Median hours of monitor use per full day in the home was 15.5 hours. Of 67 infants, 58 used the monitor for at least part of every day in the home. The number of hours of monitor use per day did not differ significantly by diagnostic category, chronologic age, alarms, maternal age, education, or insurance type. This study population of infants at increased risk of sudden infant death syndrome had excellent compliance; 75% of the infants were monitored more than 10.5 hours per day, and 25% were monitored more than 21 hours per day.
Documented monitoring provides an objective measure of compliance. These data provide a potential goal for level of compliance with home cardiorespiratory monitoring.
采用记录监测法对以下两方面进行前瞻性评估：（1）临床指征为心肺监测的婴儿的依从性水平；（2）可能影响依从性的因素：诊断、社会经济状况、母亲年龄和教育程度以及警报。
连续纳入67例婴儿（51%为女性，49%为足月儿），根据以下指征开具监测医嘱：婴儿猝死综合征受害者的兄弟姐妹（16%）、早产呼吸暂停（45%）以及明显危及生命事件或婴儿期呼吸暂停（39%）。获取人口统计学数据、警报和事件数据，以及首次监测数据下载时的监测使用总结报告。
根据监测指征，母亲年龄、教育程度和保险状况无显著差异。每使用10小时监测仪，呼吸暂停或心动过缓的警报中位数为0.7次，导联松动警报的中位数为0.6次。监测仪可在家中使用2至106天（中位数为11天）。在家中每天监测仪的使用中位数时间为15.5小时。67例婴儿中，58例在家中每天至少部分时间使用监测仪。每天监测仪的使用小时数在诊断类别、实际年龄、警报、母亲年龄、教育程度或保险类型方面无显著差异。该研究中婴儿猝死综合征风险增加的人群依从性良好；75%的婴儿每天监测超过10.5小时，25%的婴儿每天监测超过21小时。
记录监测提供了依从性的客观衡量标准。这些数据为家庭心肺监测的依从性水平提供了一个潜在目标。
