Sudden infant death syndrome: Difference between revisions
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==Background== | ==Background== | ||
*Abbreviation: SIDS | |||
*Unexpected death of infants <1yr for which no pathologic cause can be determined | *Unexpected death of infants <1yr for which no pathologic cause can be determined | ||
**Most deaths occur between 2-4 months of age | **Most deaths occur between 2-4 months of age | ||
| Line 6: | Line 7: | ||
===Risk Factors=== | ===Risk Factors=== | ||
*Prone sleeping | *Prone sleeping | ||
**Odds ratio of 4.92, one of biggest modifiable risk factors | |||
**Likely from combination of hypercarbia and hyperthermia (heat dissipated through head) | |||
*Soft bedding | *Soft bedding | ||
*Bed-sharing | *Bed-sharing | ||
| Line 14: | Line 17: | ||
*Prematurity / Developmental delay | *Prematurity / Developmental delay | ||
*Socioeconomic disadvantage | *Socioeconomic disadvantage | ||
*Mothers <20 yo | |||
*Maternal exposure to smoking, alcohol, drugs of abuse | *Maternal exposure to smoking, alcohol, drugs of abuse | ||
===Protective Factors=== | |||
*Use of pacifier | |||
*Breastfeeding | |||
*Immunizations | |||
*Home monitoring is NOT protective | |||
*Recommend safe sleep to all families (the ABC's = Alone, on Back, in Crib) | |||
==Clinical Features== | ==Clinical Features== | ||
*Unexpected death of infants <1yr for which no pathologic cause can be determined | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Sick neonate DDX}} | |||
==Evaluation== | ==Evaluation== | ||
*Examine for signs of [[nonaccidental trauma]] | |||
**Bruising, petechiae (especially to face on conjunctivae), torn frenulum, blood in mouth or nares | |||
*SIDS is a post-mortem diagnosis; ED chart should read "sudden unexpected death in infancy" | |||
==Management== | ==Management== | ||
*Infants with rigor mortis, livedo reticulrais, pH <6, or reduced temperature in absence of environmental hypothermia should not be resuscitated | *Infants with rigor mortis, livedo reticulrais, pH <6, or reduced temperature in absence of environmental hypothermia should not be resuscitated | ||
*Do not manipulate body - all cases require evaluation by coroner/ME | |||
==Disposition== | |||
*Deceased, by definition | |||
==See Also== | ==See Also== | ||
*[[ | *[[Neonatal resuscitation]] | ||
==References== | ==References== | ||
<references/> | <references/> | ||
*The Sudden Infant Death Syndrome. N Engl J Med 2009; 361:795-805 | |||
[[Category:Pediatrics]] | [[Category:Pediatrics]] | ||
Latest revision as of 03:03, 30 April 2022
Background
- Abbreviation: SIDS
- Unexpected death of infants <1yr for which no pathologic cause can be determined
- Most deaths occur between 2-4 months of age
- Rare in <1 month of age
- Diagnosis of exclusion
Risk Factors
- Prone sleeping
- Odds ratio of 4.92, one of biggest modifiable risk factors
- Likely from combination of hypercarbia and hyperthermia (heat dissipated through head)
- Soft bedding
- Bed-sharing
- Parental smoking
- URI
- Male sex
- Prematurity / Developmental delay
- Socioeconomic disadvantage
- Mothers <20 yo
- Maternal exposure to smoking, alcohol, drugs of abuse
Protective Factors
- Use of pacifier
- Breastfeeding
- Immunizations
- Home monitoring is NOT protective
- Recommend safe sleep to all families (the ABC's = Alone, on Back, in Crib)
Clinical Features
- Unexpected death of infants <1yr for which no pathologic cause can be determined
Differential Diagnosis
Sick Neonate
THE MISFITS [1]
- Trauma
- Heart
- Congenital heart disease
- Hypovolemia
- Endocrine
- Metabolic
- Sodium
- Calcium
- Glucose
- Inborn errors of metabolism
- Seizure
- Formula / feeding problems
- Intestinal Disasters
- Toxin
- Sepsis
Evaluation
- Examine for signs of nonaccidental trauma
- Bruising, petechiae (especially to face on conjunctivae), torn frenulum, blood in mouth or nares
- SIDS is a post-mortem diagnosis; ED chart should read "sudden unexpected death in infancy"
Management
- Infants with rigor mortis, livedo reticulrais, pH <6, or reduced temperature in absence of environmental hypothermia should not be resuscitated
- Do not manipulate body - all cases require evaluation by coroner/ME
Disposition
- Deceased, by definition
See Also
References
- ↑ Brousseau T, Sharieff GQ. Newborn emergencies: the first 30 days of life. Pediatr Clin North Am. 2006 Feb;53(1):69-84, vi.
- The Sudden Infant Death Syndrome. N Engl J Med 2009; 361:795-805