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Pneumograms

Are you guys still doing pneumograms on your kids or are we just stuck in the 1980s at my hospital?

SteveNNP, MSN, NP

Specializes in Neonatal ICU (Cardiothoracic).

I've never seen one done.......

Are you guys still doing pneumograms on your kids or are we just stuck in the 1980s at my hospital?

Tell me what it is...maybe we are doing them, but calling them something else.

Some people call them sleep studies or nocturnal desat studies. It's hooking tha baby up to a bunch of wires to see if they are apneic, desatting during the night.

cathys01

Specializes in NICU, CVICU.

We do them on our unit. I've seen maybe three or four in the last year, so we don't do many of them.

I thought sleep studies are normally done in older kids or adults, why is there a need for these babies particularly when they are premature. Can you elaborate further the indication for this test and the expected outcome.:confused:

We do "5 channel studies" which along with the regular HR/RR/sat also monitor esophageal pH. Never saw so many kids diagnosed with reflux as those on our unit... wonder how many kids off the street would test positive for reflux if you gave them all a 5 channel... It's become a big joke around here now.

Gompers, BSN, RN

Specializes in NICU.

We call them sleep studies. It's basically just an extra set of leads and another nelcor, so it's like double monitors. We also have a pH probe placed in the baby's throat by the respiratory therapist that sets up the studies, and get X-ray to confirm it. We label the monitor tracing that comes out with when feedings start and stop, and if they were PO or NG. We do it on babies who are either having tons of apnea, or babies who are r/o reflux.

prmenrs, RN

Specializes in NICU, Infection Control.

Diedre:

Sometimes premies that don't set off alarms for apnea/bradicardia actually have the type of breathing pattern associated w/SIDS. (Before sleep studies/whatever your facility calls them were done, premies had a higher incidence of SIDS than non premies.) Those identified can be sent home on Caffiene and a monitor. Caffiene is used to treat Apnea of Prematurity, if they're sending a baby home w/it, a monitor is indicated as well.

I think the "standard of care" in our community is to do them for kids born under a certain gestation, not sure what the number is. I'd prefer to see anyone

We seem to do them on everybody. They even do them on term babies who have had a dusky spell in newborn. I really question the value of these tests because every baby seems to fail them and they all wind up having to go home on monitors. These are often kids who haven't had an AB spell for weeks and aren't even on the pulse ox in the unit. If we aren't even monitoring their O2sats in the unit, then why do it at home?

Gompers, BSN, RN

Specializes in NICU.

I thought sleep studies are normally done in older kids or adults, why is there a need for these babies particularly when they are premature. Can you elaborate further the indication for this test and the expected outcome.:confused:

We do them to rule out the cause of apnea, desats, or irregular breathing. If it's reflux (which will show on the pH probe monitor, plus will correlate with feeds) then they will increase or change the reflux meds, or even consider a fundoplication if it's severe. If it's central apnea, the baby is given caffiene and sent home on monitors.

Now I know what is it all about, we call it PH study in my unit. We normally carry out such studies if we suspect that this premie has an indication for GER especially if the apnoeic episodes are associated with post feeding.

BittyBabyGrower, MSN, RN

Specializes in NICU, PICU, educator.

We do them on the majority of our kids. Anyone that is on caffeine or Theo...yes. On Reglan...yes. Under 34 weeks, has any history of a-b's, was or is on O2 for an extended period of time, all get one.

We don't do ph probe studies on a regular basis, the sleep study will show what kind of apnea it is (ie obstructive). When we do ph probe studies, GI comes and places the probe and the kids have to be off their reflux meds for 24 hours prior. We have a sleep study tech that does our studies...it is all computerized now, and it has cut down on the number of monitors we send kids home on....the tech is there fore the whole study and documents everything that the kids does or has done. When parents are there, no holding, cooing, bathing, etc. Only out for feeds and then right back to bed (on their back).

Sweden

Specializes in NICU, Med/Surg.

I have never seen one done in our unit.......

Anna

Nope. Only if the kid is close to going home and has a lot of brady's, especially after feeds.

walkingrock, ADN

Specializes in Retired NICU.

ph probe studies and pneumograms are not the same, although some places they do a ph probe study at the same time as a pneumogram. A ph probe study is to determine the amount of GER, a pneumogram is to determine if a baby is having apnea (that may or may not show up on a monitor) and helps to determine whether it is central (brain caused) or obstructive apnea. We seem to be doing less peumograms and more car seat challenges these days, although we still do occasional pneumograms. I'm sure it depends on the type of patients a particular unit has and the resources available to the unit, as well as the mind set of the neos. Sometimes, we want to see if the apnea is related to GER, that is why one would do a pneumogram with a ph probe at the same time...frequently these tests in the past were to document for the insurance companies so we could get equipment or resources for the baby... all the above is just my opinion, from my 26+ yrs of experience in various units...

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