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[Acute apparently life threatening events in 62 infants: anamnestic and clinical data]
1Universitäts-Kinderklinik Hamburg-Eppendorf.
Insights
This study investigated acute, life-threatening events (ALTEs) in infants, identifying an unrecognized disorder in a significant portion of cases, some of which responded to specific therapies.
Area of Science:
- Pediatrics
- Neonatology
- Emergency Medicine
Context:
- Infants admitted for acute, life-threatening events (ALTEs) presented with diverse clinical signs.
- A significant proportion of these events occurred during sleep.
- Parental reporting of infant breathing patterns was often unreliable.
Purpose:
- To analyze the clinical characteristics and outcomes of infants experiencing ALTEs.
- To identify potential underlying, unrecognized disorders contributing to ALTEs.
- To explore the role of infections and other factors in ALTEs.
Summary:
- The study included 62 infants (21 preterm, 41 full-term) admitted for ALTEs.
- Clinical data and diagnostic work-up revealed an unrecognized disorder in 34% of full-term and 14% of preterm infants.
- Infections were noted in some infants, with rotavirus identified in enteritis cases.
Impact:
- Diagnosis of an unrecognized disorder in a notable percentage of infants experiencing ALTEs.
- Potential for specific therapies in identified cases.
- Highlights the complexity of ALTEs, involving various potential etiologies including infections.
Abstract:
Among 62 infants admitted to our hospital after an acute and apparently threatening event which according to the parents required active intervention either by tactile stimulation, or shaking or mouth to mouth ventilation were 21 previously preterm babies, 12 of whom with additional perinatal risk factors, and 41 fullterm infants, 3 of them being subsequent siblings of a SIDS victim. More than 80% of the ALTEs occurred during presumed sleep while the remaining 20% were observed during wakefullness, mostly during or shortly after feeding. The majority was said to be found pale or blue, floppy and mostly unreactive. The parents or caretakers, however, were unable to give reliable information concerning the type of breathing i.e. whether the infants were apneic or not. On admission, 71% of the pre- and 63% of the fullterms showed abnormal signs and symptoms. A total of 14 infants had symptoms of respiratory tract infections, involving the lungs in only 6 cases. An other 10 infants developed moderate enteritis after admission only; 8 of them had stool cultures positive for rotavirus antigen. On the basis of the anamnestic and clinical data including the results of the diagnostic work-up in 14 (34%) of the fullterm and 3 (14%) of the preterm infants a so far unrecognized disorder was diagnosed which in many cases gave access to a specific therapy. If the cases of infections - not including those with only mild respiratory tract involvement often found in cases of SIDs or near miss SIDS - are included in this group their number increased to 27 (43,5%).(ABSTRACT TRUNCATED AT 250 WORDS)