Recommended clinical evaluation of infants with an apparent life-threatening event. Consensus document of the European Society for the Study and Prevention of Infant Death, 2003

Kahn, André

doi:10.1007/s00431-003-1365-x

Cited by 106 publications

(97 citation statements)

References 47 publications

(48 reference statements)

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“…2,27,38,99,107,108 On the basis of the information provided by the authors for these patients, it seems unlikely that events could have been classified as a lower-risk BRUE, either because the patient had a positive history or physical examination or a recurrent event. The most commonly reported disorders include fatty acid oxidation disorders or urea cycle disorders.…”

Section: B Clinicians Should Not Prescribe Acid Suppression Therapymentioning

confidence: 99%

“…The most commonly reported disorders include fatty acid oxidation disorders or urea cycle disorders. 107,109 In cases of vague or resolved symptoms, a careful history can help determine whether the infant had not received previous treatment (eg, feeding after listlessness for suspected hypoglycemia). These rare circumstances could include milder or later-onset presentations of IEMs.…”

Section: B Clinicians Should Not Prescribe Acid Suppression Therapymentioning

confidence: 99%

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Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants

Tieder¹,

Bonkowsky²,

Etzel³

et al. 2016

Pediatrics

140

154

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This is the fi rst clinical practice guideline from the American Academy of Pediatrics that specifi cally applies to patients who have experienced an apparent life-threatening event (ALTE). This clinical practice guideline has 3 objectives. First, it recommends the replacement of the term ALTE with a new term, brief resolved unexplained event (BRUE). Second, it provides an approach to patient evaluation that is based on the risk that the infant will have a repeat event or has a serious underlying disorder. Finally, it provides management recommendations, or key action statements, for lower-risk infants. The term BRUE is defi ned as an event occurring in an infant younger than 1 year when the observer reports a sudden, brief, and now resolved episode of ≥1 of the following: (1) cyanosis or pallor; (2) absent, decreased, or irregular breathing; (3) marked change in tone (hyper-or hypotonia); and (4) altered level of responsiveness. A BRUE is diagnosed only when there is no explanation for a qualifying event after conducting an appropriate history and physical examination. By using this defi nition and framework, infants younger than 1 year who present with a BRUE are categorized either as (1) a lower-risk patient on the basis of history and physical examination for whom evidence-based recommendations for evaluation and management are offered or (2) a higher-risk patient whose history and physical examination suggest the need for further investigation and treatment but for whom recommendations are not offered. This clinical practice guideline is intended to foster a patient-and family-centered approach to care, reduce unnecessary and costly medical interventions, improve patient outcomes, support implementation, and provide direction for future research. Each key action statement indicates a level of evidence, the benefi t-harm relationship, and the strength of recommendation.

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Section: B Clinicians Should Not Prescribe Acid Suppression Therapymentioning

confidence: 99%

Section: B Clinicians Should Not Prescribe Acid Suppression Therapymentioning

confidence: 99%

Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants

Tieder¹,

Bonkowsky²,

Etzel³

et al. 2016

Pediatrics

140

154

View full text Add to dashboard Cite

show abstract

“…Differences may be assigned to variations in study populations, designs (population vs. institutional) and, particularly, inclusion criteria. ALTE should be classified as a symptom or main complaint and never as a final diagnosis 9 . No treatment is available for ALTE specifically; therefore, the purpose of clinical evaluations should be the detection of the underlying cause of the event, which will define outcome and prognosis.…”

mentioning

confidence: 99%

“…No treatment is available for ALTE specifically; therefore, the purpose of clinical evaluations should be the detection of the underlying cause of the event, which will define outcome and prognosis. Cases that remain undiagnosed after initial clinical evaluation, complementary tests, and follow-up of clinical progression after hospital discharge are classified as idiopathic 3,9 . The severity of the event is determined according to clinical history, clinical examination and analysis of risk factors.…”

mentioning

confidence: 99%

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Prevalence of epilepsy and seizure disorders as causes of apparent life- threatening event (ALTE) in children admitted to a tertiary hospital

Anjos

Nunes

2009

Arq. Neuro-Psiquiatr.

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-Objective: To determine the prevalence and describe clinical characteristics of seizure disorders and epilepsy as causes of apparent life-threatening event (ALTE) in children admitted at the emergency and followed in a tertiary hospital. Method: Cross-sectional study with prospective data collection using specific guidelines to determine the etiology of ALTE. Results: During the study, 30 (4.2%) children admitted to the hospital had a diagnosis of ALTE. There was a predominance of males (73%) and term infants (70%). Neonatal neurological disorders and neuropsychomotor development delay were found respectively in 13.4% and 10% of the cases. Etiological investigation revealed that 50% of the cases were idiopathic, and 13.4% were caused by epilepsy or seizure disorders. Although all patients had recurrent ALTE events, epilepsy had not been previously suspected. Conclusion: Epilepsy should be included in the differential diagnosis of ALTE, particularly when events are recurrent.KEy worDs: ALTE, sudden infant death syndrome, epilepsy.Prevalência de epilepsia e crises epilépticas como causa de eventos com aparente risco de vida (alte ) em crianças internadas em hospital terciário resumo -Objetivo: Determinar a prevalência e características clínicas de crises epilépticas e epilepsia como causa de eventos com aparente risco de vida (ALTE) em crianças atendidas na emergência e acompanhadas em hospital terciário. Método: Estudo transversal com coleta prospectiva de dados através de protocolo específico para identificação da etiologia de ALTE. Resultados: Foram diagnosticadas 30 crianças com ALTE perfazendo 4.2% das crianças internadas no período do estudo. Houve predominância no sexo masculino (73%) e em neonatos a termo (70%). História prévia de doenças neurológicas no período neonatal e atraso no desenvolvimento neuropsicomotor ocorreram respectivamente em 13.4% e 10% dos casos. A investigação etiológica identificou 13.4% dos casos relacionados a epilepsia ou crise convulsivas e 50% idiopáticos. Apesar destes pacientes terem apresentados episódios recorrentes em nenhum caso havia a suspeita prévia de epilepsia. Conclusão: Ao investigar pacientes com ALTE a possibilidade do diagnóstico de epilepsia deve ser fortemente considerada principalmente nos casos recorrentes.PALAvrAs-CHAvE: ALTE, síndrome da morte súbita do lactente, epilepsia.

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Usefulness of Airway Evaluation in Infants Initially Seen With an Apparent Life-Threatening Event

Willis

Bonkowsky²,

Srivastava³

et al. 2011

Arch Otolaryngol Head Neck Surg

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Recommended clinical evaluation of infants with an apparent life-threatening event. Consensus document of the European Society for the Study and Prevention of Infant Death, 2003

Abstract: a systematic diagnostic evaluation, together with a comprehensive treatment programme, increases survival and quality of life for most affected infants.

Cited by 106 publications

References 47 publications

Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants

Brief Resolved Unexplained Events (Formerly Apparent Life-Threatening Events) and Evaluation of Lower-Risk Infants

Prevalence of epilepsy and seizure disorders as causes of apparent life- threatening event (ALTE) in children admitted to a tertiary hospital

Usefulness of Airway Evaluation in Infants Initially Seen With an Apparent Life-Threatening Event

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