Indikation und Nachsorgekonzept zur Heimmonitorüberwachung in der Komplexbetreuung von Früh- und Risikoneugeborenen

Zusammenfassung

In der Diskussion um den Nutzen der Heimmonitorversorgung insbesondere für das Kollektiv frühgeborener Kinder mit einem Apnoe-Bradykardie-Syndrom und/oder einer chronischen Lungenerkrankung spielt die Verkürzung des stationären Aufenthaltes nicht nur unter sozioökonomischen Gesichtspunkten sondern auch vor dem Hintergrund psychologischer und entwicklungsneurologischer Aspekte eine wichtige Rolle. Diesen Argumenten gegenüber stehen jedoch die Kosten dieser ambulanten Überwachung sowie die fehlenden Standards für die konsekutive Nachsorge dieser Kinder. Der folgende Artikel hat zum Ziel, die aktuelle Praxis der Heimmonitorverordnung und ihrer Nachbetreuung vor dem Hintergrund der Evidenzlage im Kontext der zu berücksichtigenden differenzialdiagnostischen Überlegungen am Beispiel des etablierten Konzeptes der Neonatologie und des integrierten Sozialpädiatrischen Zentrums am Dr. von Haunerschen Kinderspital der Ludwig-Maximilians-Universität in München zu diskutieren.

Abstract

The pros and cons of home monitoring especially for premature infants with continuing apneic episodes and/or chronic lung disease are an ongoing discussion. The controversy spans socio-economic requirements, medical indication as well as patient and family needs. Here, the costs of home monitoring and follow-up care on the one hand and longer hospitalization times on the other need to be considered. This article aims to create a basis for this discussion by summarizing current evidence for the indications and considerations for differential diagnoses while also outlining the established follow-up program for these patients at the Dr. v. Hauner Children’s Hospital at the Ludwig-Maximilians-University Munich, Germany.

Schlüsselwörter

Heimmonitoring - Frühgeborene - Apnoe-Bradykardie-Syndrom - chronische Lungenerkrankung (BPD) - ALTE - SIDS

Key words

home monitoring - premature infants - Apnea of prematurity - chronic lung disease (BPD) - ALTE - SIDS

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