Brief resolved unexplained event: New diagnosis in infants

Area of Science:

• Pediatrics
• Neonatal Care
• Emergency Medicine

Background:

• The term apparent life-threatening event (ALTE) was previously linked to sudden infant death syndrome (SIDS).
• This led to hospital admissions for infants experiencing acute events.
• Current guidelines recommend updated terminology and diagnostic approaches.

Purpose of the Study:

• To outline the current approach to evaluating infant near-death experiences.
• To introduce the revised terminology and diagnostic criteria for these events.

Main Methods:

• Review of a recent clinical practice guideline.
• Analysis of diagnostic criteria for brief resolved unexplained events (BRUE).

Main Results:

• The definition of ALTE has been revised to brief resolved unexplained event (BRUE).
• BRUE diagnosis in infants <1 year requires a brief, resolved event with specific symptoms (cyanosis, breathing changes, altered responsiveness) unexplained by history/physical exam.
• Low-risk infants with BRUE should not be admitted; overtesting is discouraged.

Conclusions:

• BRUE is the new terminology for ALTE.
• Clinical practice guidelines recommend a focused approach to BRUE diagnosis and management.
• Hospital admission and extensive testing are discouraged for low-risk infants.