Abstract:
:In 2016, the American Academy of Pediatrics published a clinical practice guideline that more specifically defined apparent life-threatening events as brief resolved unexplained events (BRUEs) and provided evidence-based recommendations for the evaluation of infants who meet lower-risk criteria for a subsequent event or serious underlying disorder. The clinical practice guideline did not provide recommendations for infants meeting higher-risk criteria, an important and common population of patients. Therefore, we propose a tiered approach for clinical evaluation and management of higher-risk infants who have experienced a BRUE. Because of a vast array of potential causes, the initial evaluation prioritizes the diagnosis of time-sensitive conditions for which delayed diagnosis or treatment could impact outcomes, such as child maltreatment, feeding problems, cardiac arrhythmias, infections, and congenital abnormalities. The secondary evaluation addresses problems that are less sensitive to delayed diagnosis or treatment, such as dysphagia, intermittent partial airway obstruction, and epilepsy. The authors recommend a tailored, family-centered, multidisciplinary approach to evaluation and management of all higher-risk infants with a BRUE, whether accomplished during hospital admission or through coordinated outpatient care. The proposed framework was developed by using available evidence and expert consensus.
journal_name
Pediatricsjournal_title
Pediatricsauthors
Merritt JL 2nd,Quinonez RA,Bonkowsky JL,Franklin WH,Gremse DA,Herman BE,Jenny C,Katz ES,Krilov LR,Norlin C,Sapién RE,Tieder JSdoi
10.1542/peds.2018-4101subject
Has Abstractpub_date
2019-08-01 00:00:00issue
2eissn
0031-4005issn
1098-4275pii
peds.2018-4101journal_volume
144pub_type
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