Two Alternative Pathways Leading To Sid Events

Abstract □ 109

In recent years, several items have become generally accepted as "risk factors" for SID events, predominately prone position, overheating and nicotine. Prior to information campaigns, in our own series 84% of SID deaths occurred in prone position. By performance of polygraphic studies the influence of prone position on physiological parameters was investigated. It could be demonstrated that 'face down' position may lead to substantial CO₂ rebreathing when combined with soft underbedding. By use of infrared photography the influence of different sleeping positions and environmental factors on thermoregulation was evaluated. It could be shown that in prone position heat loss through radiation is reduced, possibly leading to thermal stress. (Figure)

From epidemiological data and our own investigations it was speculated in which way the different parameters associated with SID might interact and finally lead to the fatal SID event. The hypothesis of (at least) two alternative multifactorial pathways might explain why different prevention strategies targeting different items may be equally successful concerning reduction of SIDS mortality.