PROLONGED APNEA AND THE SUDDEN INFANT DEATH SYNDROME: CLINICAL AND LABORATORY OBSERVATIONS

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 944-944
Author(s):  
Alfred Steinschneider
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Critical Role ◽  
Warning System ◽  
Sudden Infant Death ◽  
Serial Killer ◽  
Medical Examiner ◽  
Sudden Infant ◽  
Pediatric Pathology ◽  
Prolonged Apnea

A 25-Year Trail to Murder Charges—... The first suspicions were raised in 1985 by Dr. Linda Norton, a former medical examiner for Dallas County, Texas, and an expert on pediatric pathology, who had been a consultant in the VanDerSluys case. "You may have a serial killer in Syracuse," she told the prosecutor in giving him a copy of an October 1972 article in Pediatrics (1972;50(4)) called "Prolonged Apnea and the Sudden Infant Death Syndrome: Clinical and Laboratory Observations." In the report Dr. Steinschneider described his work with the syndrome and how two children in a family plagued with the affliction had died within hours of their release from his Syracuse research project. In his paper, Dr. Steinschneider concluded that the family, which he still identifies only as "H," showed that victims suffered from real if almost undetectable physical abnormalities. In a proposal that was radical then but is now accepted, he suggested that the syndrome had a genetic component and was therefore inherited. He suggested that scientists could identify the abnormalities and thereby devise a warning system. "But the paper indicated a more sinister possibility to Dr. John F. Hick of Minnesota. In a letter to the journal, he wrote that the case offered "circumstantial evidence suggesting a critical role for the mother in the death of her children." (See below.) But his warning was dismissed, until Mr. Fitzpatrick read the paper 15 years later. "The medical records described two happy, healthy, perfectly normal kids," he said. "It convinced me that these children were murdered."

Prolonged Apnea, Vagal Overactivity, and Sudden Infant Death

PEDIATRICS ◽  
1973 ◽  
Vol 51 (4) ◽  
pp. 755-755
Author(s):  
David S. Bachman
Keyword(s):  
At Risk ◽  
Vagus Nerve ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Vagal Stimulation ◽  
Sudden Infant Death ◽  
Sudden Infant ◽  
Prolonged Apnea ◽  
Stimulation Of

The article on prolonged apnea and the sudden infant death syndrome (SIDS) by Steinschneider1 is very exciting in that it suggests the possibility of identifying infants at risk from SIDS before the final event. Obviously, it is of great importance to learn the mechanism causing the preceding apneic episodes. Do they represent vagal overactivity? Stimulation of the intact vagus nerve in the unanesthetized monkey causes apnea, as well as bradycardia and even arrhythmias.2 In fact, we have seen myocardial myocytolysis secondary to vagal stimulation.3

Sudden Infant Death Syndrome and Child Abuse

PEDIATRICS ◽  
1973 ◽  
Vol 52 (1) ◽  
pp. 147-147
Author(s):  
John F. Hick
Keyword(s):  
Child Abuse ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
The Other ◽  
Sudden Infant ◽  
Common Denominator ◽  
Prolonged Apnea ◽  
The Common ◽  
Family Chronicle

In reporting two siblings who succumbed to "sudden infant death syndrome," Steinschneider exposes an unparalleled family chronicle of infant death.1 Of five children, four died in early infancy and the other died without explanation at age 28 months. Prolonged apnea is proposed as the common denominator in the deaths, yet the author leaves many questions relevant to the fate of these children unanswered. Apnea of greater than 15 seconds has been well documented for the two siblings studied.

Sudden Infant Death Syndrome and Child Abuse

PEDIATRICS ◽  
1994 ◽  
Vol 93 (6) ◽  
pp. 944-944
Author(s):  
J. F. Hick
Keyword(s):  
Child Abuse ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Sudden Infant Death ◽  
The Other ◽  
Sudden Infant ◽  
Common Denominator ◽  
Prolonged Apnea ◽  
The Common ◽  
Family Chronicle

In reporting two siblings who succumbed to "sudden infant death syndrome," Steinschneider exposes an unparalleled family chronicle of infant death.1 Of five children, four died in early infancy and the other died without explanation at age 28 months. Prolonged apnea is proposed as the common denominator in the deaths, yet the author leaves many questions relevant to the fate of these children unanswered.

Sudden Infant Death Syndrome (SIDS): The Metropolitan Dade County Experience, 1979–1983

1987 ◽  
Vol 27 (4) ◽  
pp. 283-287 ◽  
Author(s):  
Arthur R. Copeland
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Age Distribution ◽  
Sudden Infant Death ◽  
Medical Examiner ◽  
Sudden Infant ◽  
Dade County ◽  
The Family ◽  
Case Files ◽  
Death Cases

A study of Sudden Infant Death Syndrome (SIDS) or ‘crib death’ cases was performed on the case files of the office of the Medical Examiner of Metropolitan Dade County in Miami, Florida, during the years 1979 to 1983. One hundred and thirty-nine cases were collected and analysed according to: the rate per thousand live births; racial and ethnic variation in this rate; the age distribution of the victims; the race and sex of the victim; the location of the terminal incident; and the scene circumstances. The rate of occurrence of SIDS in Dade County has decreased overall in the five years studied—more so in white and Spanish-surnamed individuals than in blacks. The victim is most commonly from eight to nine weeks of age or three to six months of age. Most victims were black males. The most common scenario was being found dead after a feeding in a bed at home. Other SIDS deaths in the family were not common. The mother of the decedent most frequently found the victim and fire rescue intervention (cardiopulmonary resuscitation) occurred approximately half the time.

Prolonged Apnea and Cardiac Arrhythmias in Infants Discharged from Neonatal Intensive Care Units: Failure to Predict an Increased Risk for Sudden Infant Death Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 70 (6) ◽  
pp. 844-851 ◽  
Author(s):  
D. P. Southall ◽  
J. M. Richards ◽  
K. J. Rhoden ◽  
J. R. Alexander ◽  
E. A. Shinebourne ◽  
...  
Keyword(s):  
Intensive Care ◽  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Cardiac Arrhythmias ◽  
Neonatal Intensive Care ◽  
Sudden Infant Death ◽  
Neonatal Intensive Care Units ◽  
Sudden Infant ◽  
Prolonged Apnea ◽  
Premature Beats

Twenty-four hour recordings of respiratory wave form and ECG were made on low-birth-weight and/ or premature infants within one week of discharge from eight neonatal intensive care units. Eight infants (0.7%) had episodes of apnea >30 seconds in duration, all of which were accompanied by bradycardia <100 beats per minute; 25 infants (2.3%) had a total of 36 apneic episodes between 20 and 30 seconds in duration, 29 of which were accompanied by bradycardia ≤100 beats per minute; and 19 infants (1.7%) had episodes of bradycardia ≤50 beats per minute without prolonged apnea (as shown by a lack of breathing movement). Five infants had ventricular premature beats (including one with ventricular tachycardia). Eleven infants had supraventricular premature beats (including two with supraventricular tachycardia and one with preexcitation). Four infants had both supraventricular and ventricular premature beats. Two infants had preexcitation. Eleven infants who underwent 24-hour recordings died. Five infants were victims of sudden infant death syndrome. One infant death was sudden and unexpected and was attributed to bronchopneumonia. Two deaths were associated with congenital heart disease and three were associated with major cerebral disorders. None of the six babies who died suddenly and unexpectedly had apnea ≥20 seconds, bradycardia ≤50 beats per minute, or cardiac arrhythmias on their 24-hour recordings.

Respiratory Behavior in Near-Miss Sudden Infant Death Syndrome

PEDIATRICS ◽  
1982 ◽  
Vol 69 (6) ◽  
pp. 785-792
Author(s):  
Joan E. Hodgman ◽  
Toke Hoppenbrouwers ◽  
Susan Geidel ◽  
Anthony Hadeed ◽  
Maurice B. Sterman ◽  
...  
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Periodic Breathing ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Sleep State ◽  
Apnea Duration ◽  
Prolonged Apnea ◽  
Respiratory Variables

Seventeen infants with unexplained prolonged apnea that has been designated near-miss sudden infant death syndrome were monitored for sleep and cardiorespiratory variables during a 12-hour, all-night recording session. Infants were matched for gestational age, sex, and age at recording with control infants. Respiratory variables studied included respiratory rate, respiratory variability, apnea duration, apnea density, and periodic breathing. No statistically significant differences were found in sleep state or respiratory variables between near-miss and control infants. Eight infants (47%) had no recurrence of prolonged apnea, whereas three (17.6%) had recurrent apneic episodes for six weeks to eight months following the original episode. No clinical or polygraphic finding predicted which infant would exhibit recurrent apnea. None of the infants was monitored at home. All infants were developing normally when examined at 1 to 2 years of age.

Home Apnea Monitoring in ‘Near-Miss’ Sudden Infant Death Syndrome (SIDS) and in Siblings of SIDS Victims

PEDIATRICS ◽  
1982 ◽  
Vol 70 (1) ◽  
pp. 69-74 ◽  
Author(s):  
Paul Duffty ◽  
M. Heather Bryan
Keyword(s):  
Sudden Infant Death Syndrome ◽  
Infant Death ◽  
Additional Term ◽  
Sudden Infant Death ◽  
Near Miss ◽  
Sudden Infant ◽  
Upper Respiratory Tract ◽  
Term Infants ◽  
Electronic Monitors ◽  
Prolonged Apnea

Electronic monitors were used at home to detect apnea in 134 infants who were considered to be at risk for sudden infant death syndrome (SIDS). Seventy-two infants had idiopathic apnea at a mean age of 2.2 ± 1.4 (± 1 SD) months. Of these, 31 subsequently had prolonged apnea (> 20 seconds) with the last spell occurring at 6.2 ± 3.2 months of age. Fourteen infants required vigorous stimulation on at least one occasion and 14 had more than ten separate episodes. Eighteen infants with awake apnea had a significantly smaller chance of subsequent spells (P < .05). Ten additional term infants had apnea during the first week of life but none had subsequent episodes. Of 52 siblings of SIDS victims, only seven had had apnea before monitoring started. Sixteen had prolonged apnea while on a monitor; seven required vigorous stimulation on at least one occasion and one infant died despite cardiopulmonary resuscitation. The first documented spell in these 16 infants was at 2.6 ± 2.1 months and the last at 7.2 ± 2.7 months of age. Ten infants had more than ten subsequent spells. A tendency to clustering of spells was noted. Preceding events, especially a mild upper respiratory tract infection, were noted in 36 of the 47 infants who had apnea on the home monitor.

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