An animal model of life-threatening hyperthermia during infancy

1992 ◽  
Vol 73 (1) ◽  
pp. 340-345 ◽  
Author(s):  
D. S. Jardine ◽  
R. H. Haschke
Keyword(s):  
Animal Model ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Human Infants ◽  
Normal Body Temperature ◽  
Life Threatening ◽  
Radiant Heater ◽  
Weanling Piglets ◽  
And Control ◽  
Experimental Group

A mathematical model of heat balance in human infants suggests that it may be possible for severe hyperthermia to develop if an infant is unable to remove his blankets in response to overheating (thermal entrapment). This hypothesis was tested in an animal model of weanling piglets. Ten piglets were warmed in a radiant heater to rectal temperature of 41 degrees C to simulate a fever. Animals in the experimental and control groups were removed from the heater and covered with ordinary infant blankets (to a thickness of approximately 3 cm). Endogenously produced heat caused the animals to warm to 42 degrees C. At this point, the control animals were uncovered. They rapidly cooled to normal body temperature. Animals in the experimental group remained covered until they expired from hyperthermia at 43.9 +/- 0.7 degrees C (SD) after 96 +/- 43 (SD) min. These data show that lethal hyperthermia may result from thermal entrapment. This finding may help clarify the role that hyperthermia may play in illnesses such as hemorrhagic shock and encephalopathy syndrome and some cases of sudden infant death syndrome.

Consultation with the Specialist

1996 ◽  
Vol 17 (7) ◽  
pp. 257-259
Author(s):  
John G. Brooks
Keyword(s):  
Color Change ◽  
Muscle Tone ◽  
Close Association ◽  
Prognostic Significance ◽  
Home Monitoring ◽  
Marked Change ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Diagnostic Management ◽  
Life Threatening

Infants who experience apparent life-threatening events (ALTEs) usually generate enormous anxiety among family members and other caretakers and present diagnostic, management, and counseling challenges for the pediatrician. Important considerations for the primary care provider include the following: 1. What is the prognostic significance of the frightening event, particularly in relation to sudden infant death syndrome (SIDS)? 2. Which mechanisms and specific diagnoses should be considered as possible causes of ALTEs? 3. Which infants who present after an ALTE require hospitalization, and what diagnostic evaluation is appropriate? 4. What is the role for home cardiorespiratory monitors, and what is appropriate follow-up for infants who have suffered an ALTE? Definition ALTE should be considered a chief complaint rather than a specific diagnosis. In the standard established in 1986 by the National Institutes of Health (NIH) Consensus Development Conference on Infantile Apnea and Home Monitoring, ALTE is defined as "an episode that is frightening to the observer and is characterized by some combination of apnea (central or occasionally obstructive), color change (usually cyanotic or pallid but occasionally erythematous or plethoric), marked change in muscle tone (usually marked limpness), choking, or gagging. In some cases the observer fears that the infant has died." Previously used terminology, such as "aborted crib death" or "nearmiss SIDS," should be abandoned because it implies a possibly misleading close association between this type of event and SIDS.

scholarly journals A Common 3′UTR Variant of the PHOX2B Gene Is Associated With Infant Life-Threatening and Sudden Death Events in the Italian Population

2021 ◽  
Vol 12 ◽  
Author(s):  
Tiziana Bachetti ◽  
Simona Bagnasco ◽  
Raffaele Piumelli ◽  
Antonella Palmieri ◽  
Isabella Ceccherini
Keyword(s):  
Infant Death ◽  
Complex Traits ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Italian Population ◽  
Phox2b Gene ◽  
Common Genetic Variants ◽  
Life Threatening ◽  
Unexpected Infant Death ◽  
Hypoventilation Syndrome

Heterozygous mutations in the Paired like homeobox 2b (PHOX2B) gene are causative of congenital central hypoventilation syndrome (CCHS), a rare monogenic disorder belonging to the family of neurocristopathies and due to a defective development of the autonomic nervous system. Most patients manifest sudden symptoms within 1 year of birth, mainly represented by central apnea and cyanosis episodes. The sudden appearance of hypoxic manifestations in CCHS and their occurrence during sleep resemble two other unexplained perinatal disorders, apparent life-threatening event (ALTE) and sudden and unexpected infant death (SUID), among which the vast majority is represented by sudden infant death syndrome (SIDS). Differently from CCHS, characterized by Mendelian autosomal dominant inheritance, ALTE and SIDS are complex traits, where common genetic variants, together with external factors, may exert an additive effect with symptoms likely manifesting only over a “threshold.” Given the similarities observed among the three abovementioned perinatal disorders, in this work, we have analyzed the frequency of PHOX2B common variants in two groups of Italian idiopathic ALTE (IALTE) and SUIDs/SIDS patients. Here, we report that the c*161G>A (rs114290493) SNP of the 3′UTR PHOX2B (i) became overrepresented in the two sets of patients compared to population matched healthy controls, and (ii) associated with decreased PHOX2B gene expression, likely mediated by miR-204, a microRNA already known to bind the 3′UTR of the PHOX2B gene. Overall, these results suggest that, at least in the Italian population, the SNP c*161G>A (rs114290493) does contribute, presumably in association with others mutations or polymorphisms, to confer susceptibility to sudden unexplained perinatal life-threatening or fatal disorders by increasing the effect of miR-204 in inducing PHOX2B expression down-regulation. However, these are preliminary observations that need to be confirmed on larger cohorts to achieve a clinical relevance.

Near Miss Sudden Infant Death Syndrome Episodes? A Clinical and Electrocardiographic Correlation

PEDIATRICS ◽  
1986 ◽  
Vol 77 (6) ◽  
pp. 811-815 ◽  
Author(s):  
Ehud Krongrad ◽  
Linda O'Neill
Keyword(s):  
High Risk ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Hard Copy ◽  
Sudden Infant ◽  
Normal Infant ◽  
Objective Data ◽  
Life Threatening ◽  
High Risk Populations ◽  
Home Monitor

The study was carried out to validate objectively the relationship between clinical impressions of parents and ECG evidence of life-threatening arrhythmias in infants considered to be at high risk. Twenty infants considered to be at high risk were provided with a hospital grade home monitor with a hard copy-recording capability (n = 12) and/or an ECG telephone transmision system (n = 8). There were 93 alarms considered by the parents as true alarms. All of the ECG tracings recorded during the 93 episodes were normal. Infant stimulation was provided for 11 infants and was not administered during 82 of these alarms. None of the infants died and all are well at 1 year of age. Our data raises questions regarding parental clinical ability to correctly perceive a true near miss episode in most cases and may explain, in part, the lack of consistency noted in previously published physiologic studies of "high risk" populations. Finally, the study raises further questions regarding the use of parental impression alone without supportive objective data as an indication for therapy in the majority of such patients. Research efforts and application of therapeutic measures will benefit greatly by development of objective data to support and supplement parental clinical observations.

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