Limitations of thoracic impedance monitoring for central apnoea detection in preterm infants

Thoracic impedance respiratory monitoring (IM) is widely used in the neonatal intensive care unit (NICU) for apnoea detection in preterm infants. However, IM may fail to identify apnoeic events by misinterpreting cardiac impedance changes as breathing, particularly during bradycardia. Such false negative (FN) episodes preclude alarm initiated intervention by nurses prior to the onset of apnoea-associated bradycardia and/or hypoxia. Conversely, IM may fail to recognise shallow breathing, resulting in false positive (FP) signalling of apnoea.