Infant Breathing Disorder Center

Services and Referral

The Infant Breathing Disorder Center provides diagnostic services to physicians to help evaluate infants with respiratory disorders during sleep. Infants up to 18 months of age with a variety of breathing and sleep disorders, including clinical evidence of apnea, obstructive sleep apnea, disturbances of respiratory control, or possible gastroesophageal reflux are accepted for evaluation.

Infants referred to the Center may be evaluated as inpatients or outpatients depending upon the type and severity of the clinical presentation. Inpatient evaluation may be recommended for infants with apnea since this may be a sign of a systemic disease. The inpatient evaluation requires only a one night stay in the hospital for evaluation and close observation. Arrangements can be made for infant home monitoring, counseling and follow up by skilled staff.

Infants have been referred from Pennsylvania, New Jersey, Delaware and Maryland, and some from as far away as Florida, Hawaii and Hong Kong. In the past year alone, more than 200 practicing pediatricians and family physicians have referred infants to our program. More than 25,000 infants and young children have been evaluated since the inception of the program. We routinely evaluate 400 inpatient and 2000 outpatients per year.

Services

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Referral guidelines

Neonates and infants with the following problems are appropriate for referral:

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Sleep studies

We perform sleep studies overnight, seven days each week on the inpatient units, with nursing staff providing observation. Overnight polysomnograms are offered for neonates and infants. Patients are noninvasively monitored for respiratory pattern, airflow at the nose and mouth, heart rate and oxygen saturation. Invasive monitoring of acid gastroesophageal reflux via pH probe is also available.

High quality monitoring equipment and updated techniques are employed to ensure reliable and accurate recordings. Each study is reviewed in detail by an experienced neonatologist trained in polysomnography. A comprehensive report, recommendations and plan for follow up are provided to the referring physician.

If home cardiorespiratory monitoring is indicated, parents and other family members are provided with a monitor and trained in its use by Children's Hospital Home Care HMR/RT, or an outside durable medical equipment vendor. The Hospital's Connelly Center staff teach classes in cardiopulmonary resuscitation daily for parents and caregivers. The Center's staff also assists parents in preparing the home for infants requiring monitors or other specialized equipment, and in making arrangements with insurance, electric and telephone companies. These services help minimize the anxiety families often experience during evaluation and therapy.

Our Infant Breathing Disorder Center also provides a comprehensive follow-up program, assuring continued care of the infant after hospital discharge. The infant's referring physician receives a phone call and/or a letter by fax or mail with evaluation results and recommendations for ongoing care. The Center's support staff contacts the family at least every three weeks until the monitor can be discontinued, thus ensuring appropriate progress and recommendations. The medical staff provides 24 hour emergency call service for any acute changes in an infant's condition. Families who need additional support services are referred to community health nurses and social workers. Children's Hospital Home Care or the DME vendor provides 24 hour service for monitoring issues.

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Research

We are a center of research investigating the causes of apnea of prematurity, apnea associated with upper respiratory infections and apnea associated with gastroesophageal reflux. We also test new monitors and other related devices needed for the evaluation and treatment of apnea. Researchers in the Division of Neonatology have actively investigated these issues and have published more than 200 articles related to apnea, SIDS and newborn respiratory physiology.

The Division's accomplishments include:

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Office hours

Our office hours are Monday through Friday, from 8 a.m. to 4 p.m. You may use voice mail, 215-590-1657, after hours and we will return your call the next business morning. The Respiratory Care Department provides overnight, weekend and holiday coverage.

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Appointments

To make an appointment for a study, please call 215-590-1657.

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