Infants presenting with ALTE are frequently discharged with home cardiorespiratory monitoring. While reassuring to many parents, home monitoring may increase psychosocial and financial stress. Although not proven to predict adverse outcomes, pneumogram evaluation is often used to select patients for monitoring. Accordingly, we sought to determine the clinical and pneumogram characteristics of ALTE patients discharged with and without home monitoring. Data was collected on 32 consecutive infants with ALTE who had 6 channel pneumogram evaluations. Pneumogram evidence of central apnea was defined as an event >15 seconds during the 12 hour period. Monitoring was recommended in 19 (59%) infants including 4 infants whose ALTE required CPR. Clinical and 12 hour pneumogram characteristics of infants with and without monitors are shown. Table
In summary, the characteristics of pneumograms in infants recommended for home monitoring were similar to those who did not receive a monitor. Interestingly, a history of maternal public assistance was associated with home monitoring. We conclude that the decision to use home monitors after ALTE is not based on pneumogram results. Additional studies relating pneumogram evaluation, home monitoring and clinical outcomes should clarify the clinical roles for these modalities.
