HOME MONITORING DECREASES SUDDEN INFANT DEATH SYNDROME (SIDS) IN HIGH-RISK PRETERM INFANTS. 1669

The article by Steinschneider and Santos in this issue of Pediatrics,1 is one in a series2-6 in which a relatively new technique of on-line recordings of cardiorespiratory function is used. This technique has been used mainly during home monitoring of infants considered to be at high risk for sudden infant death syndrome (SIDS). It allows for objective on-line recording of cardiorespiratory anomalies and their correlation with parental observation. The authors have monitored 155 siblings of infants who died of SIDS, whom they considered to be epidemiologically at risk. Many alarms were reported for both apnea and bradycardia. Many parents felt a need to stimulate the infants or to provide cardiopulmonary resuscitation, either because of monitor alarms or because they perceived clinical changes in respiratory pattern, color, or behavior, which they believed to be of a life-threatening nature.

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False alarms in the nursery

PEDIATRICS ◽

10.1542/peds.61.4.665 ◽

1978 ◽

Vol 61 (4) ◽

pp. 665-666

Author(s):

J. F. L.

Keyword(s):

Intensive Care ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Home Monitoring ◽

Sudden Infant Death ◽

Alarm Calls ◽

Sudden Infant ◽

False Alarms ◽

Intensive Care Nursery ◽

The Cost

British police no longer answer burglar-alarm calls with enthusiasm. Who can blame them? Statistics indicate that 98.8% of automatic burglar-alarm calls are false. It is estimated that false alarms are costing British taxpayers $36 million a year.1 What connection does this observation have with pediatrics? The article by Kelly et al. in this issue (p. 511) recommends home monitoring with apnea alarms to perhaps abort the sudden infant death syndrome (SIDS) in a group of infants judged to be at risk. I can't help but wonder about the "cost" of false alarms in this situation and in the intensive care nursery, where their use is universal.

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`Near-Miss' for Sudden Infant Death Syndrome Infants: A Clinical Problem

PEDIATRICS ◽

10.1542/peds.71.5.726 ◽

1983 ◽

Vol 71 (5) ◽

pp. 726-730

Author(s):

Ronald L. Ariagno ◽

Christian Guilleminault ◽

Rowena Korobkin ◽

Margaret Owen-Boeddiker ◽

Roger Baldwin

Keyword(s):

Preterm Infants ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Specific Treatment ◽

Sudden Infant Death ◽

Near Miss ◽

Sudden Infant ◽

Term Infants ◽

Medical Evaluation

Three hundred six infants were referred for evaluation of "near-miss" sudden infant death syndrome (SIDS) from 1973 to 1980. Following the hospitalization and medical evaluation, there were 156 infants (115 term and 41 preterm) for whom there was no explanation for the presenting event and who were considered near-miss infants; 88% of these infants were seen during the first 3 months of life. A repeat near-miss event was reported in 63% (term) and 83% (preterm) infants. Twelve percent of term infants and 17% of the preterm infants had ten or more repeat events. A home apnea/cardiac monitor was prescribed for 88% of the infants for an average duration of 5.6 months in term infants and 3.5 months in preterm infants. Monitoring had been discontinued in 69% of the infants by 7 months of age. One full-term infant was later a SIDS victim. The risk of a repeat nearmiss event is concluded to be sufficiently great to demand immediate hospitalization, medical evaluation, home monitoring when there is no specific treatment, and close clinical follow-up. Follow-up studies are needed to determine whether there is any long-term morbidity for infants who have had near miss events.

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High Risk Groups for Sudden Infant Death Syndrome in Israel

Pediatric Research ◽

10.1203/00006450-199905020-00037 ◽

1999 ◽

Vol 45 ◽

pp. 10A-10A

Author(s):

Naama Rotem ◽

Rinat Rivlis ◽

Pnina Zadka

Keyword(s):

High Risk ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Risk Groups ◽

Sudden Infant Death ◽

Sudden Infant

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The Effect of Maternal Smoking and Drinking During Pregnancy Upon3H-Nicotine Receptor Brainstem Binding in Infants Dying of the Sudden Infant Death Syndrome: Initial Observations in a High Risk Population

Brain Pathology ◽

10.1111/j.1750-3639.2007.00093.x ◽

2008 ◽

Vol 18 (1) ◽

pp. 21-31 ◽

Cited By ~ 42

Author(s):

Jhodie R. Duncan ◽

Leslie L. Randall ◽

Richard A. Belliveau ◽

Felicia L. Trachtenberg ◽

Bradley Randall ◽

...

Keyword(s):

High Risk ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Maternal Smoking ◽

Sudden Infant Death ◽

Sudden Infant ◽

High Risk Population ◽

Risk Population ◽

Nicotine Receptor

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Sudden Infant Death Syndrome: Beyond Risk Factors

Life ◽

10.3390/life11030184 ◽

2021 ◽

Vol 11 (3) ◽

pp. 184

Author(s):

Serafina Perrone ◽

Chiara Lembo ◽

Sabrina Moretti ◽

Giovanni Prezioso ◽

Giuseppe Buonocore ◽

...

Keyword(s):

High Risk ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Complex Model ◽

Sociocultural Factors ◽

Sudden Infant ◽

Special Focus ◽

Effective Prevention ◽

Death Scene

Sudden infant death syndrome (SIDS) is defined as “the sudden death of an infant under 1 year of age which remains unexplained after thorough investigation including a complete autopsy, death scene investigation, and detailed clinical and pathological review”. A significant decrease of SIDS deaths occurred in the last decades in most countries after the beginning of national campaigns, mainly as a consequence of the implementation of risk reduction action mostly concentrating on the improvement of sleep conditions. Nevertheless, infant mortality from SIDS still remains unacceptably high. There is an urgent need to get insight into previously unexplored aspects of the brain system with a special focus on high-risk groups. SIDS pathogenesis is associated with a multifactorial condition that comprehends genetic, environmental and sociocultural factors. Effective prevention of SIDS requires multiple interventions from different fields. Developing brain susceptibility, intrinsic vulnerability and early identification of infants with high risk of SIDS represents a challenge. Progress in SIDS research appears to be fundamental to the ultimate aim of eradicating SIDS deaths. A complex model that combines different risk factor data from biomarkers and omic analysis may represent a tool to identify a SIDS risk profile in newborn settings. If high risk is detected, the infant may be referred for further investigations and follow ups. This review aims to illustrate the most recent discoveries from different fields, analyzing the neuroanatomical, genetic, metabolic, proteomic, environmental and sociocultural aspects related to SIDS.

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Are Infants With Bronchopulmonary Dysplasia at Risk for Sudden Infant Death Syndrome?

PEDIATRICS ◽

10.1542/peds.93.5.774 ◽

1994 ◽

Vol 93 (5) ◽

pp. 774-777

Author(s):

Peter H. Gray ◽

Yvonne Rogers

Keyword(s):

Birth Weight ◽

Preterm Infants ◽

Bronchopulmonary Dysplasia ◽

Sudden Infant Death Syndrome ◽

Infant Death ◽

Sudden Infant Death ◽

Sudden Infant ◽

Close Monitoring ◽

Increased Risk

Objective. To compare the incidence of sudden infant death syndrome (SIDS) and apparent life-threatening event (ALTE) in infants with bronchopulmonary dysplasia (BPD) and birth weight-matched control infants in view of the changing pattern of chronic lung disease of prematurity. Methods. The study population consisted of 78 preterm infants of 26 to 33 weeks gestation who were diagnosed as having BPD and discharged. The 78 control infants were matched with the study infants for birth weight categories. Infants unable to maintain adequate oxygenation without supplemental oxygen when they were feeding well and thriving were discharged on home oxygen. All infants were at least 8 months of age at follow-up and information concerning the occurrence of any ALTE was obtained by direct parent interview. Results. No infant died during the period of follow-up. Seven (8.9%) of the study group compared with eight (10.5%) of the control infants had an ALTE. Three infants (one study, two control infants) were hospitalized for further investigation. No infant discharged on the home oxygen program had an ALTE. Conclusions. The data from this study suggest that preterm infants with BPD are not at increased risk from SIDS compared with preterm infants without this condition. This may be related to close monitoring of the infants' oxygenation status and the provision of home oxygen when appropriate, which should eliminate episodes of unrecognized and untreated hypoxemia. Home monitoring for infants with BPD may not be warranted.

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Sudden Infant Death Syndrome in Infants Evaluated by Apnea Programs in California

PEDIATRICS ◽

10.1542/peds.77.4.451 ◽

1986 ◽

Vol 77 (4) ◽

pp. 451-458 ◽

Cited By ~ 2

Author(s):

Sally L. Davidson Ward ◽

Thomas G. Keens ◽

Linda S. Chan ◽

Bradley E. Chipps ◽

Stephen H. Carson ◽

...

Keyword(s):

Sudden Infant Death Syndrome ◽

Infant Death ◽

Home Monitoring ◽

Sudden Infant Death ◽

Sudden Infant ◽

Term Infants ◽

Technical Errors ◽

Nonaccidental Trauma ◽

Increased Risk ◽

Home Monitor

Home apnea/bradycardia monitoring is frequently used in the management of infants at increased risk for sudden infant death syndrome (SIDS). However, some infants have died despite evaluation by infant apnea programs, and the benefits of home monitoring remain unproven. To determine the SIDS rate and risk factors of infants evaluated by infant apnea programs, 31 apnea programs and ten home monitor vendors in California were surveyed. Eleven (35%) of the apnea programs and four (40%) of the vendors responded. Information was obtained on 26 infants who died. Thirteen (50%) deaths were due to SIDS. Abnormal sleep studies did not predict death. Fifteen infants died despite a recommendation for home monitoring. Seven deaths occurred in association with technical errors or noncompliance with monitoring. Four deaths were due to nonaccidental trauma. The apnea programs evaluated 3,406 infants during a 5-year period; 1,841 had monitoring recommended. Term infants with apnea, subsequent siblings of SIDS victims, and infants evaluated at referral centers were more likely to have monitoring recommended than premature infants with apnea or infants evaluated at nonreferral centers (P < .0001). Infants who had monitoring recommended were at equal risk of dying of SIDS as those who did not.

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