Abstract
Infants with a history of an apparent life-threatening event that received mouth-to-mouth resuscitation (ALE-R) are high risk for sudden death (SID). Investigation of 114 infants (median age 2.8 months; 15 with SID in siblings; 20 born preterm) who had single (n=64) or recurrent (50) ALE-R revealed, compared to controls 12, 38 with abnormal hypoxaemia on a 12 hour physiological recording (with accompanying clinical events in 21). Home event recording of TcpO2, breathing movements, ECG ± SaO2 was performed in 46 infants for a median duration 1.4 months: this produced further physiological data in 22 infants.
In 49 infants, mechanisms for ALE-R were found, including: respiratory events suggestive of intrapulmonary shunting (n=29), seizure induced hypoxaemia (7), imposed upper airway obstruction (7), fabricated history/data (4) and pallor without hypoxaemia/arrhythmia (3). 104 infants underwent home TcpO2 monitoring (median duration 6 months): 2 patients died suddenly - non-compliance (1) & discontinued pO2 monitor (1).
Multi-channel physiological recordings ± event capture can provide information relevant to the diagnosis and management of these infants.
1 Slebbens VA, Poets CF. Alexander JR et at. Arch Dis Child 1991:66:569-573
2 Poets CF, Stebbens VA, Alexander JR et at. Arch Dis Child 1991:66:574-578
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Samuels, M., Poets, C., Noyes, J. et al. THE MECHANISMS FOR APPARENT LIFE-THREATENING EVENTS. Pediatr Res 32, 633 (1992). https://doi.org/10.1203/00006450-199211000-00171
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DOI: https://doi.org/10.1203/00006450-199211000-00171