Home monitoring in Hawaii: the first 1,000 patients.

By February 1988, 1,000 Hawaii infants had been prescribed cardiorespiratory monitors for use at home. By 1986, 12.3/1000 live births were being monitored, principally for apnea related to prematurity but also following Apparent Life Threatening Episodes, (ALTE) as subsequent siblings of Sudden Infant Death Syndrome (SIDS) victims, and for an increasing variety of other conditions. Less than 3% of families used the monitor less than 1 week; 30% discontinued sooner than the program recommended. Twenty-seven percent of the monitored infants were judged to have experienced real apnea or bradycardia while on their monitors. Seventeen of the patients are known to be dead, with 2 of these deaths occurring while the symptomatic patient was not monitored. Parents responding to a quality assurance questionnaire were highly enthusiastic about monitoring and felt it was a source of reassurance rather than a stressor. Major problems encountered by monitoring families were related to equipment performance.