Category: Pediatrics
Keywords: apparent life threatening event (PubMed Search)
Posted: 5/18/2012 by Mimi Lu, MD
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There has been no link found between Sudden Infant Death Syndrome (SIDS) and an Acute Life Threatening Event (ALTE)
There are several factors that dispute previous claims of each being manifestations of the same disease state:
1) Timing: approx 75-80% of SIDS deaths occur between midnight and 6 AM; 80-85% of ALTE occur between 8 AM and 8 PM
2) Prevention: Interventions to prevent SIDS (ex, “back to sleep”) have not resulted in a decreased incidence of ALTE
3) Risk factors:
a. SIDS: prone sleeping, bottle feeding, maternal smoking
b. ALTE: repeated apnea, pallor, history of cyanosis, feeding difficulties
BONUS PEARL: A thorough history and physical will lead to the diagnosis for the source of the ALTE in 21%
Pertinent historical items: detailed bystander history of event (parents, EMS), activity and behavior prior to event and any past medical issues or medications (focus on GERD and pulmonary)
Pertinent physical exam: detailed neurological and cardiopulmonary system eval with focus on signs of non-accidental trauma (retinal hemorrhaging, bulging fontanel, bruising) as up to 10% of ALTEs involve some form of abuse
