OB/GYN

West Penn Allegheny Health System Infant Apnea Center

The Neonatology Department of The Western Pennsylvania Hospital, along with medical researchers nationwide, have been actively investigating the relationship between infantile apnea and SIDS for many years. In an effort to meet the considerable needs of these high-risk infants and their families in one setting, The Western Pennsylvania Hospital has developed the Infant Apnea Center.

The first of its kind in Pittsburgh, the Infant Apnea Center offers a comprehensive program to evaluate, manage and monitor babies at risk for SIDS. West Penn’s program is the only one in existence in western Pennsylvania to be recognized by the National Association for Apnea Professionals as a comprehensive center. From referral to resolution, the Center’s focus is to provide the specific services required by these high-risk children and their parents. Primary healthcare responsibility for the infant remains with the family’s private physician.

Apnea and SIDS

What is Apnea?

Apnea refers to temporary pauses in breathing, usually during sleep. Although common among many infants, apnea is considered abnormal when it occurs too often, lasts beyond 20 seconds, or is associated with a low heart rate or a color change.

What is SIDS?

SIDS is the sudden, unexplained death of an infant that remains unexplained after the performance of a complete postmortem investigation, including an autopsy, an examination of the scene of death, and a review of the case history.

Current statistics indicate that:

• SIDS is the single largest cause of post-neonatal infant mortality.
• SIDS deaths usually occur between the first month and the first year of life, most frequently between the second and fourth months.
• Presently, one of every 500 infants born in the United States dies of SIDS.

Is there Evidence of a Relationship between Apnea and SIDS?

• While research has not yet identified the cause of SIDS conclusively, it has cast some strong suspicions. As many as half of all SIDS deaths are found, upon autopsy, to suggest recurrent low oxygen levels. These results could be caused by recurrent apnea.

When Should an Infant Undergo Evaluation?

Infants who display the following symptoms are considered to be at possible risk for SIDS and should undergo evaluation:

• Infants who stop breathing or demonstrate irregular respirations.
• Infants who have experienced pale, dusky or limp episodes.
• Premature infants with apnea and/or bradycardia that persists after 36 weeks gestation.
• Infants who have breathing problems during feedings.
• Infants at risk for prolonged apnea due to other medical problems, such as gastroesophageal reflux or seizures.
• Infants whose siblings have died from SIDS.

The Evaluation Process

Diagnostic Procedures

The evaluation of each infant begins at West Penn Hospital with a series of screening tests, usually lasting 24 hours. The Infant Apnea Center staff is equipped to conduct the sensitive respiratory studies necessary to disclose a reliable picture of an infant’s breathing pattern. These specialized measures include sophisticated medical studies such as multichannel polysomnographic sleep evaluation with nasal thermistor – pneumocardiography, pulse oximetry and esophageal pH probe studies. Following the infant’s evaluation, the staff focuses their attention on the infant’s family.

Patient Education

The Infant Apnea Center provides a variety of patient education materials and training, which includes teaching each family the techniques of cardiopulmonary resuscitation.  For those infants who require home monitoring, the Infant Apnea Center manages as many details as possible for parents during this stressful time. The staff contacts the equipment supply company, arranges for delivery of the monitor, and trains the family in its use. The staff also assists families in preparing their homes for the monitored infant, and assures them of the Center’s continued accessibility after they leave the hospital.

Emotional Support

The Western Pennsylvania Hospital’s Social Service Department is available to any family in the Center for assessment or counseling, in addition to the support provided by the neonatologists, coordinator of the Infant Apnea Center and the staff nurses.

Patient Management

Following discharge, continued care is essential to the welfare of an infant with apnea and to the child’s family. The Center’s after-care program is designed to fulfill a variety of needs that may surface when the baby returns home.

As soon as a baby is discharged, the Center sends a complete record of the infant’s hospitalization to his or her referring physician. The Center will continue to provide the pediatrician with periodic updates regarding the child’s status.

The Infant Apnea Center staff immediately begin a series of routine contacts with the family that continue until the baby’s initial problem is resolved. These contacts serve as a status check on the child and reassure the family of ongoing support.

Additional support is also available through the following:

• Whenever necessary, the Center makes referrals to community health, nursing and social service agencies.
• The Center’s medical staff is available 24 hours a day in emergency situations to manage any acute changes in an infant’s condition.
• The monitor equipment provider offers 24-hour emergency service through the Center.
• The Center’s staff arranges follow-up testing, and, when appropriate, recommends discontinuation of the monitor.

Outpatient Services

Continued close care is essential to the welfare of an infant with apnea and the child’s family. The Outpatient Infant Apnea Center provides guidance to families along with routine contacts – office visits and follow-up phone calls – to serve as both status checks on the child and reassurance of ongoing support.

Patient Referral

To refer a patient to the Infant Apnea Center or to learn more about the Center’s services, please call Louise Slezak, coordinator, at 412-578-5590.