What is included in the evaluation of a brief resolved unexplained event (BRUE) (apparent life-threatening event) (ALTE) in symptomatic or non-low-risk infants?

Updated: Feb 28, 2019
  • Author: Patrick L Carolan, MD; Chief Editor: Girish D Sharma, MD, FCCP, FAAP  more...
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Answer

Answer

Diagnostic evaluation for symptomatic infants or infants falling outside of the BRUE "low-risk" group may include the following [15] :

  • A CBC count to screen for the presence of systemic viral or bacterial infection or anemia [16]

  • Serum chemistry levels to assess for hypoglycemia, hyponatremia, hyperkalemia, acidemia, hypocalcemia, or elevation of serum lactate and pyruvate

  • ABG to assess for acidosis or retention of carbon dioxide

  • Serum and/or urine toxicology studies for possible ingestions

  • Specific bacterial or viral cultures to assess for respiratory syncytial virus (RSV), pertussis, bacteremia, or urinary tract infection

  • ECG to assess for long QT syndrome and preexcitation that suggests supraventricular tachycardia or other dysrhythmia

  • EEG to assess for epileptiform activity

  • Upper GI contrast studies to assess for swallowing dysfunction, thin liquid aspiration, or upper-intestinal anatomic malformations

  • Impedance pH monitoring to assess for gastroesophageal reflux disease

  • Neuroimaging to assess for hemorrhage or structural CNS abnormality

  • Polysomnography to assess for sleep-based disturbances in cardiorespiratory control


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