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[Apropos of 100 cases of malaise in infants]
Insights
Gastroesophageal reflux and vagal hyperreflectivity are common causes of life-threatening events in infants. Medical treatment for GER was effective in 90% of cases, with specific medications showing good tolerance and efficacy.
Area of Science:
- Pediatrics
- Neonatology
- Cardiology
Context:
- Infants experiencing apparently life-threatening events require comprehensive evaluation.
- Identifying underlying causes is crucial for effective management and prevention of recurrence.
Purpose:
- To investigate the causes of apparently life-threatening events in hospitalized infants.
- To evaluate the efficacy of medical interventions for identified conditions.
Summary:
- 100 infants with apparently life-threatening events were studied, with gastroesophageal reflux (66%) and vagal hyperreflectivity (13%) being the most frequent diagnoses.
- Medical treatment for GER demonstrated 90% effectiveness, with metoclopramide and diphemanil methylsulfate showing significant results for GER and vagal hyperreflectivity, respectively.
- Further investigations included cardiorespiratory monitoring, and management strategies were tailored to specific etiologies.
Impact:
- This study highlights the significant role of GER and vagal hyperreflectivity in infant life-threatening events.
- Effective medical management strategies were identified, improving outcomes for affected infants.
- Findings support targeted diagnostic workups and therapeutic approaches for infants presenting with these events.
Abstract:
Among 4,411 children hospitalized from May 1985 through April 1987, 100 infants (mean age three months) had exhibited an apparently life-threatening event. Management included careful history taking by interviewing parents, a thorough physical evaluation, routine laboratory tests, and cardiorespiratory monitoring. A variety of further investigations were usually performed to look for gastroesophageal reflux (GER), vagal hyperreflectivity, or sleep-related cardiorespiratory disorders. Leading causes, that often occurred in combination, included GER (66 per cent of cases), and vagal hyperreflectivity (13%). Atypical breath-holding spells, ENT causes, and neurological causes were documented in 8%, 6% and 5% of cases respectively. Medical treatment of the GER proved effective in 90% of cases. Metoclopramide (Primperan, 10 drops/kg/d) was effective in 62% of infants with GER and was well tolerated. Diphemanil methylsulfate (Prantal, 10 mg/kg/d) satisfactorily controlled vagal hyperreflectivity. Monitoring was prescribed in 43% of cases.