乳幼児のBRUE(Brief Resolved Unexplained Event)に関する最新情報:エビデンス、リスク層別化、および乳幼児のケア改善
Brit Long1, Anna M DePompolo2, Michael Gottlieb3
1Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA.
Introduction:
Brief resolved unexplained events (BRUEs) can occur in a large number of pediatric patients, with most having a benign etiology. However, in many cases, these can result in unnecessary evaluations and admissions among low-risk patients. Therefore, it is critical for clinicians to be aware of the current evidence regarding BRUE in the emergency department (ED) setting.
Objective:
This paper evaluates key evidence-based updates concerning pediatric BRUE for the emergency clinician.
Discussion:
A BRUE is defined as a clinical entity occurring in an infant less than 1 year of age that an observer reports as sudden, brief (< 1 min), and now resolved episode with no explanation and accompanied by at least one of the following: Change in breathing, pallor or cyanosis, change in tone, or altered level of consciousness. BRUEs often cause significant distress for both caregivers and medical professionals. Having an approach to risk-stratification and engaging in shared decision-making with caregivers can help guide clinicians during these encounters. Clearly identifying what qualifies as a low-risk event can minimize unnecessary testing while ensuring that children who do not meet low-risk criteria receive an appropriately focused evaluation CONCLUSION: An understanding of the current literature concerning BRUE can assist emergency clinicians and improve the care of these patients.
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